Morphological Changes of Meibomian Gland in Anopthalmic Patients Wearing PMMA Prosthetic Eyes

Background: Chronic ocular discomfort represents one of the most common adverse events referred to patients with long-standing ocular prosthesis wearing.

Aim and Objectives: The current work aimed to evaluate the morphological changes of meibomian gland in unilateral anophthalmic patients wearing PMMA prosthetic eyes in relation to contralateral normal eye.

Subjects and Methods: This work has been performed upon 40 eyes of patients with anopthalmic socket wearing PMMA prosthetic eye completed a questionnaire designed to identify MGD-related ocular symptoms. Both eyelids of each patient underwent slit lamp examination, meibography imaging, and microbilogical assessment. Intra-individual comparison of main outcome measures between the eyelids of a prosthetic eye and paired normal eyelids was performed using Wilcoxon signed-rank test. A linear mixed model was employed to evaluate the relationship between ocular symptoms and meibomian gland/tear characteristics.

Results: The eyelids with an ocular prosthesis exhibited significantly higher scores for ocular symptoms, lid margin abnormality, meibomian gland expression, and meibography compared to the normal eyelids (p<0.01 for all scores). The meibography score was significantly positively connected with the ocular symptom score and negatively correlated with tear parameters (p<0.01 for all parameters, linear mixed model).

Conclusions: With a prosthetic eye, meibomian glands of the eyelids are more likely to be lost. Accordingly, deterioration and loss of normal anatomical structures might lead to obstructive MGD, which was strongly associated with dry eye ocular symptoms.

These findings suggest that patients with prosthetic eyes, particularly those experiencing ocular discomfort, may benefit from clinical screening and care recommendations for MGD.