Relationship Between Chronic Ocular Surface And Meibomian Gland Changes And Clinical Scores In Cicatricial Conjunctival Diseases
Published 2025 - 43rd Congress of the ESCRS
Reference: PO603 | Type: Free paper | DOI: 10.82333/4c1a-1v06
Authors: Ori Ratzon 1 , Ofri Rimoni 2 , Eleanor Gafni Klepfish 1 , Arie Marcovich* 3
1Ophthalmology,Kaplan Medical Center,Rehovot,Israel, 2Ophthalmology,Shamir Medical Center,Zeriffin,Israel, 3Ophthalmology,Kaplan Medical Center,Rehovot,Israel;Faculty of Medicine,Hebrew University ,Jerusalem,Israel
Purpose
This study aimed to evaluate long-term structural and functional changes in the meibomian glands and lid margin keratinization after the chronic and quiescent phase of cicatricial conjunctival diseases. Additionally, the study explored the impact of these changes on dry eye severity and the ocular surface, as well as their correlation with compherensive composite symptom scoring.
Setting
This study was conducted in a tertiary ophthalmology clinic, department of cornea.
Methods
A total of 64 patients were included: 22 patients with ocular cicatricial pemphigoid (OCP), 24 patients with Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS-TEN), and 18 patients with graft-versus-host disease (GVHD). Patients were assessed using the "Cicatrising Conjunctivitis Assessment Tool", and their previous surgical histories (ocular surface and eyelid) were recorded. Tear film function parameters (Schirmer, TBUT, NI-BUT), clinical staging of the meibomian glands and lid margin changes, and OSDI (Ocular Surface Disease Index) scores were documented.
Results
Meibomian gland dysfunction (MGD) and dry eye were the most common chronic findings. OCP patients had the highest composite scores and meibomian gland changes, while GVHD patients exhibited more severe dry eye. Significant correlations were found between scarring severity and MGD parameters (expression, r=0.426, p<0.001; secretion quality, r=0.425, p<0.001; lid margin changes, r=0.439, p<0.001). Disease severity was significantly linked to OSDI and TBUT (r=0.506, p<0.001; r=-0.257, p=0.041). No significant differences in lid margin keratinization were found among the three groups (p=0.098), though more advanced MGD findings were observed in patients with lid margin keratinization (p=0.029).
Conclusions
In ocular cicatricial diseases, lid margin keratinization and meibomian gland dysfunction play a critical role in determining long-term ocular surface survival and functional recovery, depending on disease severity. Comprehensive scoring systems that assess the relationship between ocular morbidity and long-term ocular surface parameters offer valuable insights for improved patient classification and treatment strategies.