The effect of treatment of primary congenital glaucoma on meibomian glands and tear film.

PURPOSE: To evaluate meibomian gland (MG) and tear film alterations in treated primary congenital glaucoma (PCG) patients through a comparative study.

METHODS

We conducted a comparative, cross-sectional study analysing eyes with treated PCG vs healthy eyes of age-matched children using the MediWorks Dry Eye Diagnostic System to perform a non-contact quantitative analysis. Seven ocular parameters were measured: non-invasive break-up time (NIBUT), tear meniscus height, lipid layer thickness, eyelid edge morphology, MG morphology, ocular surface staining, and conjunctival hyperaemia.

RESULTS

Our study included 71 treated PCG eyes (42 patients) and 30 non-glaucomatous healthy eyes (30 patients). Thirty (21 patients) of the 71 treated PCG eyes (42.3%) were on topical glaucoma medications at the time of study enrolment. MG loss grade (1.3 ± 0.5 vs 0.1 ± 0.3, P < 0.001), mean first rupture NIBUT (7.2 ± 2.6 s vs 11.9 ± 2.4 s, P < 0.001), lipid layer grade (3.2 ± 0.6 vs 3.6 ± 0.5, P = 0.03), and prevalence of low tear meniscus height (46.5% vs 93.3%, P < 0.001) were all significantly altered in the treated PCG group as compared to healthy controls. Sub-group analyses revealed significantly worse MG and tear film parameters in treated PCG eyes on glaucoma medications vs treated PCG eyes not on glaucoma medications and treated PCG eyes not on glaucoma medications vs healthy controls. Glaucoma surgery was also associated with worse parameters.

CONCLUSION

In this first study to evaluate MG and tear film parameters in treated PCG, significant differences were observed in the MG morphology and tear film parameters of eyes with treated PCG compared to the eyes of healthy children. Glaucoma medication use and glaucoma surgery were individually correlated with ocular surface disease in treated PCG.