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Global improvement in meibomian glands after chalazion surgery demonstrated by meibography

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Abstract

Purpose

To evaluate the use of meibography as an objective measure of the effects of incision & curettage (I&C) chalazion surgery on meibomian gland loss and morphology as well as dry eye syndrome.

Methods

This prospective, interventional clinical study included adult patients with a primary chalazion which persisted despite conservative treatment. All patients underwent I&C surgery. The following parameters were compared both preoperatively and 21 days postoperatively: meibography, tear breakup time (TBUT), Schirmer test, meibum expression, tear meniscus height, meibomian gland dysfunction (MGD) grading, and the Ocular Surface Disease Index (OSDI).

Results

Thirty eyelids were enrolled in the study. The mean age ± SD was 40.56 ± 13.94 years. Meibography demonstrated a significant decrease in meibomian gland loss (P = 0.00) and improvement in morphology. The most common meibomian gland pathology preoperatively noted was morphological signs of atrophy that included fluffy areas and tortuous glands. Both of these findings improved postoperatively (P = 0.04 and P = 0.02, respectively). There were a significant change in MGD grading and a significant decrease in meibum expression score postoperatively (P = 0.00). TBUT and tear meniscus height also improved significantly (P = 0.00 and P = 0.003, respectively). The OSDI score improved significantly as well (P = 0.00).

Conclusion

While incision and drainage surgery is a time-honored, standard treatment for chalazion, meibography now demonstrates a global improvement in the meibomian glands, not just the ones involved with the chalazion. In addition to the improvements in the clinical and dry eye syndrome parameters improvements, meibography findings demonstrate that early I&C surgery restores the meibomian glands architecture significantly.

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Acknowledgements

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Funding

The authors declare that no funds, grants, or other support was received during the preparation of this manuscript.

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Authors and Affiliations

  1. Ophthalmology Department, Baruch Padeh Medical Center, Dov Hoz 0., 15208, Poriya, Israel

    Saleem Hanna, Slava Shor & Shirin Hamed Azzam

  2. Ophthalmology Department, Shamir Medical Center, Tzrifin, Israel

    Morris Hartstein

  3. Estemed Clinic, Kfar Kanna, Israel

    Abed Mukari

  4. Rheumatology Unit, Laniado hospital, Netanya, Israel

    George Habib

Authors
  1. Saleem Hanna
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  2. Morris Hartstein
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  3. Abed Mukari
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  4. Slava Shor
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  5. George Habib
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  6. Shirin Hamed Azzam
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Dr. SH, Dr. SHA, and Dr. GH. The first draft of the manuscript was written by Dr. SHA, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shirin Hamed Azzam.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Consent to participate and publish

Informed consent was obtained from all individual participants included in the study.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Baruch Padeh medical center (Date 9/10/2019/No. 0078–19-POR).

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Hanna, S., Hartstein, M., Mukari, A. et al. Global improvement in meibomian glands after chalazion surgery demonstrated by meibography. Int Ophthalmol 42, 2591–2598 (2022). https://doi.org/10.1007/s10792-022-02307-4

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  • DOI: https://doi.org/10.1007/s10792-022-02307-4

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