Abstract
Purpose: :
To retrospectively review results of intraductal meibomian gland probing with adjunctive intraductal microtube steroid injection for patients with Meibomian Gland Dysfunction manifested by more severe symptoms and/or signs including lid tenderness (LT) and excluding lid tenderness (XLT).
Methods: :
Charts were reviewed of patients status post MGP for MGD as previously described in Cornea 2010;29:1145-1152. Indications for probing include LT in 11 patients and XLT in 5 patients. Due to severity of signs/symptoms, an intraductal injection of steroid through sterile microtubes was performed immediately after probing. Severity of symptoms were evaluated pre and post procedure using VAS. Inclusion criteria required pre probing VAS greater than 25mm.
Results: :
For MGPs for LT, average age was 58.5 with range from 23-82. Sixteen lids of 11 patients had pre probe VAS of 44.1 + 13.9 and had immediate reduction of 49% with further reduction of 67% at less than one month, 79% at one month, 94% at one to three months and 81% at 3-6 months. The average last VAS was reduced 66% at average follow up of 2.5 + 3.1 months. For MGPs for XLT, average age was 67 with range from 59-74. Thirteen lids of 5 patients had pre probe VAS of 72.9 + 14.4 with immediate reduction of 41% with further reduction of 53% at less than one month, 88% at one month, 60% at 2-3 months, and 40% at 3-6 months. The average last VAS was reduced 36.5% at average follow up of 4.23 + 2.68 months. Symptoms which improved included lid pressure, burning and stinging and photophobia.
Conclusions: :
Meibomian gland probing with adjunctive intraductal microtube steroid injection has been successfully performed and tolerated without adverse sequelae. The addition of intraductal steroid to probing for these severe cases of MGD may have enabled clinical improvement to a peak of 94% relief from LT and 88% relief from XLT.
Keywords: cornea: tears/tear film/dry eye • eyelid