XXXVII Congress of ESCRS, Paris, Fransa, 14 - 18 Eylül 2019, ss.125-126
Purpose: The purpose of the study was to determine the chronic impact of alkali burn on ocular surface and Meibomian glands (MG).
Methods: Ten patients who had a history of unilateral alkali injury at least 12 months earlier and who have related unilateral limbal stem cell deficiency were included in to this cross-sectional study (10 alkali burn eyes (Group 1), 10 healthy eyes (Group 2)). All cases underwent a detailed ophthalmological examination including ocular surface scoring (COASTL), Schirmer 1 test, tear-film break up time, Ocular Surface Disease Index (OSDI) score assessment and evaluation of the Meibomian glands using infrared filter of slit-lamp biomicroscope (SL-D701, TOPCON, Tokyo, Japan) device. The Meibomian glands were graded from grade 0 (no loss of Meibomian glands) to grade 3 (gland dropout >2/3 of the total Meibomian glands).
Results: The mean age of the patients was 42.10±8.30 (31-56) years. Male to female ratio was 9/1. The mean duration between chemical injury and Meibomian gland evaluation was 121.60±159.78 (12-504) months. The mean best corrected visual acuity in Group 1 and 2 were 1.15±0.70; 0 and 0.0 LogMAR, respectively (p<0.0001). The mean ocular surface scores in Group 1 and 2 were 7.40±2.01 and 0±0, respectively (p<0.0001). The mean Schirmer 1 test results in Group 1 and 2 were 21.90±11.66 and 21.20±8.43 mm, respectively (p=0.905). The mean tear-film break up time …. The mean OSDI scores in patients were 71.69±26.50. The average upper eyelid meiboscores in Group 1 and 2 were 1.8 ±0.91 and 0.66 ±0.73, respectively (p=0.83). The lower eyelid meiboscores in Group 1 and 2 were 0,6 ±0.84 and 0.20 ±0.42, respectively (p=0.018).
Conclusions: Alkali burn of the ocular surface may have a direct effect on eyelid margin and cause Meibomian gland orifice damage and meibum secretion impairment. Besides, alkali exposure may also directly damage the Meibomian gland or may affect the gland through local inflammation. In this case series, it was demonstrated that the Meibomian gland damage is statistically significant in lower eyelids. As a conclusion, detailed evaluation of the alterations in the Meibomian glands following alkali burn needs further investigation.