Topical Antiglaucoma Treatment With Prostaglandin Analogues May Precipitate Meibomian Gland Disease

Abstract

The popular use of topical prostaglandin analogues (TPAs) in glaucoma patients has a well-documented association with changes in number, length, thickness, and growth pattern of eyelashes. A link between meibomian gland disease and seborrheic blepharitis resulting from topical administration of prostaglandin analogues has not been made to the authors' knowledge. A retrospective study of 43 patients presenting for incision and curettage of chalazion to the operating theatre over a 2-year period was performed. The patients' histories were reviewed to establish whether they were using TPAs for glaucoma at the time of surgery. Eight patients (19%) were using TPAs at the time of surgery. No patient had a history of eyelid margin disease before the commencement of TPAs. The exact pathogenesis of how meibomian gland disease is linked to TPA use is unclear. We postulate that the topical application of prostaglandin analogues may contribute to the formation of chalazion by acting directly to stimulate meibomian gland secretion. The authors present the findings of a preliminary case series showing a higher-than-expected incidence of patients using TPAs requiring surgical intervention for chalazion.