Meibomian gland inversion correction effective for epiphora treatment in patients with facial nerve palsy

Written by Dr. Shravani Dali Published On 2023-12-08T19:30:24+05:30 | Updated On 8 Dec 2023 7:30 PM IST

Meibomian gland inversion correction effective for epiphora treatment in patients with facial nerve palsy suggests a new study published in the Ophthalmic Plastic and Reconstructive Surgery.

A study was done 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.

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.

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

Meibomianglandinversioncorrectioneffectiveforepiphoratreatmentinpatientswithfacialnerve palsyOphthalmic Plastic and Reconstructive Surgery

Source : Ophthalmic Plastic and Reconstructive Surgery

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.