Abstract
PurposeTo evaluate morphological alterations of meibomian glands (MGs) in the dry anophthalmic socket syndrome (DASS).MethodsFifteen unilateral anophthalmic patients wearing cryolite glass prosthetic eyes were enrolled. All patients with clinical blepharitis or other significant eyelid abnormalities were excluded. In vivo laser scanning confocal microscopy (LSCM) of the MGs in the lower eyelids both on the anophthalmic side and the healthy fellow eye was performed to quantify acinar unit density, acinar unit diameter, acinar unit area, meibum secretion reflectivity, the inhomogeneous appearance of the glandular interstice, and inhomogeneous appearance of the acinar walls.ResultsThe lower eyelids of the anophthalmic sockets revealed a significant reduction of the acinar unit density (p = 0.003) as well as a significantly more inhomogeneous appearance of the periglandular interstices (p = 0.018) and the acinar unit walls (p = 0.015) than the healthy fellow eyelid. However, there were no significant differences regarding the acinar unit diameter, acinar unit area, and meibum secretion reflectivity of the MGs on the anophthalmic side compared to the healthy fellow eyelid (p ≥ 0.05, respectively).ConclusionsThe eyelids of anophthalmic sockets without clinical blepharitis demonstrate a reduced density of MG acinar units and a more inhomogeneous appearance of the periglandular interstices and the acinar unit walls. This can cause meibomian gland dysfunction contributing to DASS and suggests early treatment of these symptomatic patients, even in the clinical absence of any blepharitis signs.
Highlights
A majority of the anophthalmic patients suffer from dry anophthalmic socket syndrome (DASS) resulting inThe authors are not aware of any systematic, prospective study investigating and quantifying morphological changes of meibomian glands (MGs) in anophthalmic sockets without signs of clinical blepharitis until now
DASS has been defined as a disease of the socket surface characterized by a loss of tear film homeostasis accompanied by socket discomfort, in which tear film instability, conjunctival inflammation, and damage, as well as eyelid and neurosensory abnormalities, play etiological roles [35]
The purposes of the present study were to evaluate potential morphological changes of MGs in anophthalmic sockets without clinical blepharitis using in vivo confocal laser scanning microscopy to compare the morphology of the MGs with the heathy fellow eye, to evaluate dry anophthalmic socket symptoms in these patients, and to investigate factors associated with potential morphological changes of the MGs
Summary
A majority of the anophthalmic patients suffer from dry anophthalmic socket syndrome (DASS) resulting in. The authors are not aware of any systematic, prospective study investigating and quantifying morphological changes of meibomian glands (MGs) in anophthalmic sockets without signs of clinical blepharitis until now. We are unaware of any study comparing the morphology of MGs of anophthalmic sockets with the healthy fellow eye in these patients [35]. The purposes of the present study were to evaluate potential morphological changes of MGs in anophthalmic sockets without clinical blepharitis using in vivo confocal laser scanning microscopy to compare the morphology of the MGs with the heathy fellow eye, to evaluate dry anophthalmic socket symptoms in these patients, and to investigate factors associated with potential morphological changes of the MGs
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