Prevalence and associated factors of meibomian gland dysfunction and dry eye disease among subjects presenting for transepithelial photorefractive keratectomy.

INTRODUCTION

Transepithelial Photorefractive Keratectomy (Trans-PRK) is a modern refractive surgery that improves comfort and recovery but may predispose to meibomian gland dysfunction (MGD) and dry eye disease (DED), causing postoperative discomfort. Preoperative assessment of meibomian glands among Trans-PRK candidates remain limited. This study aimed to determine the prevalence of MGD and DED, identify associated factors, and assess the correlation of meibomian gland loss (MGL) among subjects undergoing Trans-PRK at Hospital Pakar Universiti Sains Malaysia.

MATERIALS AND

METHODS

A descriptive cross-sectional study was conducted from January 2024 to January 2025 among 110 subjects aged 20-45 years undergoing preoperative Trans-PRK evaluation. Demographic, occupational, and lifestyle data were collected, while ocular surface parameters were assessed through clinical examination, meibography, and standardized questionnaires. MGD and DED were diagnosed based on established criteria. Statistical analyses were performed using SPSS version 29.0.

RESULTS

The prevalence of MGD and DED was 17.3% and 19.1%, respectively, with a mean age of 32.76 ± 7.65 years. Screen exposure exceeding four hours daily was significantly associated with MGD (OR = 9.05, 95% CI: 2.14- 38.28, p = 0.003) and DED (OR = 8.12, 95% CI: 2.16-30.54, p < 0.001). Increasing age increased the odds of MGD (OR = 3.65, 95% CI: 1.15-11.51, p = 0.027), while male gender was a significant risk factor for both. MGL correlated moderately with OSDI (r = 0.58) and meibum quality (r = 0.46), and weakly with meibum expressibility (r = 0.35) and corneal fluorescein staining (r = 0.36). Common gland changes were dropout (29.1%), tortuosity (25.5%), and shortening (20.9%).

CONCLUSION

MGD and DED were observed in 17.3% and 19.1% of Trans-PRK candidates. Age, male gender, and screen exposure were associated with MGD, while male gender and screen exposure were associated with DED. MGL correlated with key ocular surface indices, highlighting the importance of comprehensive preoperative ocular surface assessment.