Meibomian gland changes and influencing factors following cataract surgery.

PURPOSE: Meibomian gland dysfunction (MGD) is a leading cause of evaporative dry eye disease (DED), and its exacerbation after cataract surgery has been reported. This study aims to evaluate meibomian gland (MG) morphological and functional changes following cataract surgery and identify influencing factors.

METHODS

This prospective, observational study included 132 patients who underwent phacoemulsification with intraocular lens implantation. Meibomian gland loss (MGL) and non-invasive tear break-up time (NI-BUT) were assessed preoperatively at postoperative week one, and at month one using a corneal topography device via infrared meibography (Sirius, CSO, Italy). Correlations between MGL, NI-BUT, cataract grade, and surgery duration were analyzed.

RESULTS

Postoperatively, MGL increased at week one (32.0% ± 15.1) and month one (30.9% ± 14.5) compared to preoperative values (15.1% ± 7.0). NI-BUT decreased at both time points (week one: 6.8 s ± 4.3; month one: 6.7 s ± 4.6; preoperative: 9.4 s ± 4.5). A significant correlation was found between increased MGL and longer surgery duration (p < 0.001). ROC analysis identified a surgical duration threshold of 11.5 min, beyond which MGL changes were more pronounced.

CONCLUSIONS

Cataract surgery induces significant MG changes, with increased MGL and reduced NI-BUT postoperatively. Longer surgical duration is a key risk factor for MG deterioration. These findings highlight the importance of ocular surface management in cataract surgery to improve postoperative outcomes.