Impact of pterygium on the ocular surface and meibomian glands

Wanzeler, Ana Cláudia Viana; Barbosa, Ítalo Antunes França; Duarte, Bruna Aparecida Rodrigues; Barbosa, Eduardo Buzolin; Borges, Daniel Almeida; Alves, Mônica

doi:10.1371/journal.pone.0213956

Cited by 16 publications

(27 citation statements)

References 21 publications

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“…Several studies have discovered an association between meibomian gland dysfunction and pterygium. 6,10,22 One of these studies mentioned that the meibomian gland loss area was predominantly located on the nasal side in eyes with pterygium. 6 This idea is supported by the present investigation examining the correlation between meibomian gland dysfunction and pterygium location.…”

Section: Discussionmentioning

confidence: 99%

“…10 Although several theories such as long-term compression by direct contact or disruption of the microenvironment by inflammatory mediators have been proposed, the pathogenesis of this condition has yet to be determined. 6,10 In the current study, dry eye symptoms, the prevalence and severity of meibomian gland dysfunction, and the relationship between meibomian gland dysfunction and pterygium location were evaluated in patients with pterygium and compared with the results from healthy volunteers.…”

mentioning

confidence: 99%

“…1 There is evidence of an association between pterygium and dry eye. [4][5][6] However, revealing its complex relationship with the ocular surface and tear film function is difficult. Many authors have argued that the tear film functions are impaired first, and this deterioration constitutes a risk factor for pterygium.…”

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confidence: 99%

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The Influence of Pterygium on Meibomian Glands and Dry Eye Parameters

Devebacak¹,

Teker

Palamar

2023

Optom Vis Sci

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SIGNIFICANCE: Mechanical factors are also associated with meibomian gland dysregulation in patients with pterygium. Dry eye parameters were assessed, and the results support the association between pterygium and dry eye disease.PURPOSE: This study aimed to investigate how meibomian gland dysfunction and dry eye parameters relate to the existence of pterygium.METHODS: Patients with pterygium and healthy volunteers of similar age and demographic characteristics were included. Schirmer 1 test, Ocular Surface Disease Index score, fluorescein tear film breakup time, and ocular surface staining scores (Oxford score) were recorded. Meiboscores were estimated based on meibomian gland loss rate on infrared meibography (SL-D701; Topcon, IJssel, the Netherlands). The symmetry of meibomian gland loss with respect to eyelid midline was assessed.RESULTS: Fifty-four eyes with pterygium (group 1) and 50 eyes of healthy volunteers (group 2) were included. The mean ages were 54.0 ± 12.3 and 52.3 ± 8.0 years, respectively. Schirmer 1 test results and tear film breakup time were lower in group 1 (P = .007, P < .001). Oxford and Ocular Surface Disease Index scores were significantly higher in group 1 (P = .009, P < .001). The mean meiboscores were significantly higher in group 1 (P < .001). There was meibomian gland depletion in 90.7% (49 of 54) of group 1 and 32% (16 of 50) of group 2 (P < .001). Meibomian gland loss region was distributed asymmetrically in 75.5% (37 of 49) of the eyes in group 1, but not in any of the eyes in group 2. The asymmetry was located on the side where the pterygium was detected in 94.5% (35 of 37) of these eyes.CONCLUSIONS: Meibomian glands are influenced morphologically and functionally in eyes with pterygium. The overlap of the pterygium location and meibomian gland abnormality suggests a direct mechanical relationship. In managing pterygium patients, the possibility of meibomian gland dysfunction and associated evaporative dry eye should be considered.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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The Influence of Pterygium on Meibomian Glands and Dry Eye Parameters

Devebacak¹,

Teker

Palamar

2023

Optom Vis Sci

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“…In support of our findings, a prior study argued that pterygium excision has a remarkable astigmatism effect on the posterior surface of cornea, and the effect of astigmatism increased with age and higher preoperative posterior astigmatism [ 19 ]. Pterygium not only causes corneal irregularities, conjunctival congestion, and tear film changes but also has a significant impact on the ocular surface by directly changing the morphology of the meibomian gland, causing visible symptoms and potential signs of dysfunction [ 20 ]. After treatment, BUT and SIT levels in the two groups increased, and the study group was significantly higher than the control group, suggesting that the treatment can effectively improve the symptoms of dry eye and improve the function of the lacrimal gland.…”

Section: Discussionmentioning

confidence: 99%

Acupoint Massage plus Recombinant Bovine Basic Fibroblast Growth Factor Ophthalmic Gel and Limbal Stem Cell Transplantation on Visual Quality, Corneal Refraction, and Aesthetic Outcome in Patients with Pterygium

Zhang

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the clinical study of acupoint massage combined with recombinant bovine basic fibroblast growth factor (rbFGF) ophthalmic gel combined with limbal stem cell transplantation on visual quality, corneal refraction, and aesthetic outcome in patients with pterygium. Methods. Sixty patients with pterygium treated in People’s Hospital of Lujiang County from March 2018 to May 2021 were randomized into the control group and the research group by the random number table method, with 30 cases in each group. The control group received rbFGF plus limbal stem cell transplantation. The research group was treated with acupoint massage additionally. Results. The total clinical effective rate in the study group was higher than that in the control group ( P < 0.05 ); after treatment, the modulation transfer function (MTF) cutoff and Strehl ratio (SR) levels in the study group were significantly higher than those in the control group, and the tear film-related objective scatter index (TF-OSI) was significantly lower than that in the control group ( P < 0.05 ); corneal horizontal curvature and corneal vertical curvature in the study group after treatment were significantly higher than those in the control group, and corneal astigmatism degree (CAD) levels were significantly lower than those in the control group ( P < 0.05 ); the levels of the break-up time (BUT) and Schirmer test (SIT) in the study group were significantly higher after treatment, compared with the control group ( P < 0.05 ); and the incidence of adverse manifestations in the study group was significantly lower than that in the control group ( P < 0.05 ). Conclusion. Acupoint massage combined with rbFGF ophthalmic gel combined with limbal stem cell transplantation is effective in clinical treatment of pterygium.

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“…The current study showed higher MGD in pterygium patients in comparison to the controls, which is similar to the previous results. [15][16][17][18] This can be explained on the basis of the notion that the direct contact of pterygium with palpebral conjunctiva squeezes the MGs which leads to alterations in glands. Still, a detailed study is needed to determine the pathological process of MGD and unstable tear film in pterygium patients.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Parameters of Eye and Associated Histological Features are Potential Risk Factors for Development of Pterygium

et al. 2021

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Background and Objectives: Pterygium occurs throughout the world but the exact pathogenesis is still not clear. The reports on the association between eye anatomical parameters and presence of pterygium is controversial, similarly how the histological features of the pterygium may differ due to these parameters is not known. Thus, the focus of this study was to explore this gap by assessing and comparing the anatomical parameters of eye in pterygium patients and in healthy controls. In addition, histological features of pterygium were assessed and correlated with the eye anatomical parameters of the patients. Methods: Forty-one pterygium patients of age range 25-70 years undergoing surgery were included in the study after taking written informed consent. Forty-two age and sex matched healthy controls were also recruited for assessing anatomical eye parameters. Relevant history with demographic details of every subject was obtained. All participants underwent a thorough ophthalmic examination. Assessment of orbital protrusion and interpalpebral distance was measured by millimeter scale. Tear film breakup time (TFBUT) and Schirmer test was used for tear film assessment. Presence of any meibomian gland dysfunction (MGD) was examined by slit lamp. Post-surgical tissue samples from patients were assessed for histological features with H& E, PAS & Verhoeff stains. Data were processed and analyzed by using SPSS version 21.0. Results: Eyeball protrusion and MGD was found higher in pterygium patients as compared to controls. Basement membrane fragmentation on histology significantly correlated with the eyeball protrusion (P<0.04) and TFBUT (P<0.020), inflammation significantly correlated with the MGD (P<0.05) while elastosis showed significant correlation with TFBUT (P<0.001). Conclusion: It can be concluded that eye anatomical parameters might be the risk factors in the development of pterygium. The correlation between certain histological features & eye anatomical parameters indicate that anatomical eye parameters can be taken as risk factor for recurrence in these patients.

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Impact of pterygium on the ocular surface and meibomian glands

Cited by 16 publications

References 21 publications

The Influence of Pterygium on Meibomian Glands and Dry Eye Parameters

The Influence of Pterygium on Meibomian Glands and Dry Eye Parameters

Acupoint Massage plus Recombinant Bovine Basic Fibroblast Growth Factor Ophthalmic Gel and Limbal Stem Cell Transplantation on Visual Quality, Corneal Refraction, and Aesthetic Outcome in Patients with Pterygium

Anatomical Parameters of Eye and Associated Histological Features are Potential Risk Factors for Development of Pterygium

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