Abstract

Objective The aims of our experiment were to compare the microorganisms in meibomian gland secretions from patients with internal hordeolum before and after treatment using hypochlorous acid eyelid wipes, to elucidate the mechanism underlying hypochlorous acid eyelid wipe treatment of internal hordeolum. Methods This was a prospective, matched-pair study. A total of eight patients with internal hordeolum who attended the ophthalmology clinic of our hospital from April to August 2020 were included. Meibomian gland secretions were collected from subjects before treatment (Group A) and from patients cured after eyelid cleaning with hypochlorous acid eyelid wipes for 7 days (Group B). Samples were submitted to 16S rRNA high-throughput sequencing, and the resulting data were analyzed to compare the differences in the structure and composition of meibomian gland secretion microbial flora before and after treatment of internal hordeolum. Results A total of 2127 operational taxonomic units were obtained from the two groups of samples, and there was no significant difference in alpha diversity before and after eyelid cleaning. At the phylum level, there was no significant difference between the two groups. The predominant phyla in Group A included the following: Firmicutes (32.78% ± 20.16%), Proteobacteria (26.73% ± 7.49%), Acidobacteria (10.58% ± 11.45%), Bacteroidetes (9.05% ± 6.63%), Actinobacteria (8.48% ±1.77%), and Chloroflexi (3.15% ± 3.12%), while those in Group B were the following: Proteobacteria (31.86% ± 9.69%), Firmicutes (29.07% ± 24.20%), Acidobacteria (11.33% ± 7.53%), Actinobacteria (7.10% ± 1.98%), Bacteroidetes (5.39% ± 5.17%), and Chloroflexi (3.89% ± 3.67%). Starting from the class level, significant differences in microbial communities were detected before and after eyelid cleaning (P < 0.05). Linear discriminant analysis effect size analysis showed the core flora in Group A microbiome comprising Actinobacteria, Staphylococcus, Staphylococcaceae, Staphylococcus aureus, Ruminococcacea UCg-014, Ruminococcacea-UCG-014, Halomonadaceae, Neisseria, Methylobacterium, Frankiales, and Neisseria sicca, while those in Group B microbial were Streptococcus sp., Blautia, Bifidobacterium pseudocatenulatum, Subdoligranulum, Subdoligranulum variabile, Faecalibacterium, and Faecalibacterium prausnitzii. Conclusion Eyelid cleaning with hypochlorous acid eyelid wipes does not change the biodiversity in the meibomian gland secretions of patients with internal hordeolum. Hypochlorous acid eyelid wipes may affect the internal hordeolum through broad-spectrum antibacterial action to effectively reduce the relative abundance of symbiotic pathogens, such as Staphylococcus, Neisseria, Actinomycetes, and Ruminococcus and increase that of Faecalibacterium prausnitzii and other symbiotic probiotics with anti-inflammatory effects.

Highlights

  • A hordeolum is an acute suppurative reaction within the eyelid glands that is usually staphylococcal in origin

  • A total of eight patients with internal hordeolum (2 males and 6 females) were enrolled in this study, and a total of 16 samples were collected before and after eyelid cleaning with hypochlorous acid eyelid wipes, to generate pretherapy (Group A) and posttherapy (Group B) group samples, respectively

  • Many studies have reported significant differences in the microbiomes of patients with ocular surface diseases such as blepharitis, meibomian gland dysfunction, dry eye, and keratitis, compared with healthy people [25,26,27,28,29]; there has been a lack of comparative studies of microorganisms in these diseases before and after treatment, and investigating the changes in microbial communities will be helpful in understanding the pathogenesis of internal hordeolum, as well as prevention and treatment methods

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Summary

Introduction

A hordeolum is an acute suppurative reaction within the eyelid glands that is usually staphylococcal in origin. According to different disease sites, hordeolum can be medically divided into external (Zeis gland or Moll gland) and internal (meibomian gland) types [1, 2]. This study focuses solely on the internal hordeolum. The clinical manifestations of internal hordeolum are a swollen red eyelid with a painful lump that appears spontaneously within a few days and purulent inflammation of the meibomian glands [3,4,5]. Lederman et al reported that internal hordeolum pathogenesis was caused by the infection of the glands with Staphylococcus (Staphylococcus epidermidis or Staphylococcus aureus) [3, 4]. Staphylococcus is an opportunistic pathogen in the internal hordeolum, reducing pathogen invasion is the key to treatment

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