Meibomian Gland Inversion Correction Effective for Epiphora Treatment

A new study published in the Ophthalmic Plastic and Reconstructive Surgery suggests that meibomian gland inversion correction is effective for treating epiphora in patients with facial nerve palsy.

Study Overview

A study was conducted to assess epiphora outcomes using the TEARS grading score in patients with concomitant meibomian gland inversion (MGI) and facial nerve palsy (FNP) undergoing correction of MGI.

This was a retrospective, 5-year, noncomparative, single-center study of patients with MGI and FNP, treated with MGI correction under the supervision of a single surgeon. A validated “TEAR” score was used to assess changes in epiphora.

Results

Ten patients with FNP, MGI, and epiphora were analyzed from a group of 160 patients with FNP who underwent MGI surgery between 2017 and 2022. The mean age at surgery was 50 years (range, 13–76 years).

• T, E, and A scores significantly improved (p < 0.05).
• Eighty percent of patients saw a reduction in tearing frequency (T), with 60% gaining ≥ 2-grade improvement.
• Improvements in clinical effects (E) and activity limitation (A) were seen in 80% of patients, with 40% and 50% gaining ≥ 2-grade improvement, respectively.
• R scores (related to reflex tearing) improved by 60%, with 40% seeing ≥ 2-grade improvement.
• Nine patients (90%) improved symptomatically with an average improvement “S” score of 65% over a mean follow-up period of 30 months.
• All patients demonstrated restoration of the normal anatomical position of the meibomian glands.

Conclusion

MGI can cause epiphora in patients with FNP and may explain cases where symptoms persist despite standard surgical intervention. This study provides proof of concept that MGI correction can improve epiphora and that identifying MGI may be considered a critical step in the treatment algorithm for epiphora in patients with FNP.

Reference

Yvon, Camille M.B.B.S., M.Sc., F.R.C.Ophth; Malhotra, Raman M.B.Ch.B., F.R.C.Ophth. Improvement in Epiphora Using TEARS Grading Following Surgical Treatment of Meibomian Gland Inversion in Patients With Facial Nerve Palsy. Ophthalmic Plastic and Reconstructive Surgery 39(6):p 621-627, November/December 2023. | DOI: 10.1097/IOP.0000000000002458

Keywords

Meibomian, gland, inversion, correction, effective, for, epiphora, treatment, in, patients, with, facial, nerve palsy, Yvon, Camille; Malhotra, Raman