Meibomian Gland Dysfunction On Post- Photorefractive Keratectomy (Prk) Pain And Symptoms In Asymptomatic Patients

This study aims to investigate the impact of MGD on the postoperative symptoms of asymptomatic patients undergoing PRK. We hypothesize that patients with higher MGD levels may experience more severe postoperative symptoms, including pain, tear production, light sensitivity, and burning sensations.

Care Vision Laser Center, Tel Aviv, Israel.

A retrospective study, All patients who underwent PRK performed by a single surgeon (IK) at the Care-Vision Laser Center within 1st July 2020 to 30th January 2023. Subjects were categorized into 2 groups based on MGD severity, and completed questionnaires on the fourth-day post-surgery to report symptoms such as pain, tearing, burning, and light sensitivity.

MGD Severity groups: 

Group 1: patients with preoperative asymptomatic clinically insignificant MGD (defined as MGD score 1–2).

Group 2: patients with preoperative asymptomatic clinically significant MGD (defined as MGD score ≥ 3).

A total of 132 asymptomatic patients who underwent PRK surgery were included in the study. Half of these patients (50%) had asymptomatic clinically insignificant MGD (MGD score 1–2), while the other half (50%) had asymptomatic clinically significant MGD (MGD score ≥ 3). Compared to those with minimal or no MGD, patients with significant MGD preoperatively reported greater postoperative Pain (P=0.04), tearing (P=0.05), and burning sensation(P=0.04).

This study highlights the potential for MGD to exacerbate post-PRK symptoms even in asymptomatic individuals and the need for thorough preoperative ocular surface assessments, including asymptomatic MGD evaluations, to predict better and manage postoperative outcomes and optimize patient satisfaction in refractive surgery.