The Influence of Pterygium on Meibomian Glands and Dry Eye Parameters.

SIGNIFICANCE: Mechanical factors are also associated with Meibomian gland dysregulation in patients with pterygium. Dry eye parameters were assessed, and the results support the association between pterygium and dry eye disease.

PURPOSE: To investigate how Meibomian gland dysfunction and dry eye parameters relate to the existence of pterygium.

METHODS: Patients with pterygium and healthy volunteers of similar age and demographic characteristics were included. Schirmer 1 test, Ocular Surface Disease Index (OSDI) score, fluorescein tear film break-up time and ocular surface staining scores (Oxford score) were recorded. Meiboscores were estimated based on Meibomian gland loss rate on infrared meibography (SL-D701; Topcon, Netherlands). The symmetry of Meibomian gland loss with respect to eyelid midline was assessed.

RESULTS: 54 eyes with pterygium (Group 1) and 50 eyes of healthy volunteers (Group 2) were included. The mean ages were 54.0 ± 12.3 and 52.3 ± 8.0 years, respectively. Schirmer 1 test results and tear film break-up time were lower in Group 1 (P = .007, p < .001). Oxford and OSDI scores were significantly higher in Group 1 (P = .009, p < .001). The mean meiboscores were significantly higher in Group 1 (P < .001). There was Meibomian gland depletion in 90.7% (49:54) of Group 1 and 32% (16:50) of Group 2 (P < .001). Meibomian gland loss region was distributed asymmetrically in 75.5% (37:49) of the eyes in Group 1, but not in any of the eyes in Group 2. The asymmetry was located on the side where the pterygium was detected in 94.5% (35:37) of these eyes.

CONCLUSIONS: Meibomian glands are influenced morphologically and functionally in eyes with pterygium. The overlap of the pterygium location and Meibomian gland abnormality suggests a direct mechanical relationship. In managing pterygium patients, the possibility of Meibomian gland dysfunction and associated evaporative dry eye should be considered.