The role of meibomian gland dysfunction on the development of dry eye disease in patients with facial nerve palsy

ABSTRACT Purpose: To investigate whether meibomian gland dysfunction is the cause of dry eye in facial nerve palsy and to identify the possible relationship between the grades and durations of facial nerve palsy and meibomian gland dysfunction. Methods: This prospective observational study included 63 patients with unilateral facial nerve palsy. Facial nerve function and severity were assessed using the House-Brackmann grading system. Unaffected contralateral eyes were used as the control group. The following parameters were compared: tear breakup time, Schirmer 1 test score, area and density scores for corneal fluorescein staining, eyelid abnormality, meibomian gland expression, meibography scores, and areas of meibomian gland loss. A Pearson correlation analysis was performed between the grades and durations of facial nerve palsy and meibomian gland dysfunction. Results: The eyes affected by facial nerve palsy demonstrated significantly lower tear breakup time (p<0.001) and significantly higher values for corneal fluorescein staining (p<0.001), Schirmer 1 test score (p=0.042), lid abnormality score (p<0.05), meibomian gland expression level (p=0.005), meibography scores (p<0.05), and areas of meibomian gland loss (p<0.05). The grade and duration of facial nerve palsy significantly correlated with meibomian gland dysfunction (p<0.05). Conclusions: Meibomian gland dysfunction has a significant contribution to the development of dry eye disease after facial nerve palsy. Furthermore, a strong correlation was observed between the grades and durations of facial nerve palsy and meibomian gland dysfunction.

摘要 研究目的：探讨睑板腺功能障碍（meibomian gland dysfunction）是否为面神经麻痹（facial nerve palsy）相关性干眼症（dry eye disease）的致病原因，并明确面神经麻痹分级、病程与睑板腺功能障碍之间的潜在关联。研究方法：本前瞻性观察研究（prospective observational study）共纳入63例单侧面神经麻痹患者。采用House-Brackmann面神经功能分级系统（House-Brackmann grading system）评估面神经功能与病情严重程度，以患者健侧眼作为对照组。对以下指标进行组间比较：泪膜破裂时间（tear breakup time）、Schirmer I试验（Schirmer 1 test）评分、角膜荧光素染色面积与密度评分、眼睑异常情况、睑板腺分泌状态、睑板腺照相（meibography）评分及睑板腺缺失面积。采用Pearson相关分析探讨面神经麻痹分级、病程与睑板腺功能障碍之间的相关性。研究结果：面神经麻痹患侧眼的泪膜破裂时间显著缩短（P<0.001），而角膜荧光素染色评分、Schirmer I试验评分、眼睑异常评分、睑板腺分泌水平、睑板腺照相评分及睑板腺缺失面积均显著升高（分别为P<0.001、P=0.042、P<0.05、P=0.005、P<0.05、P<0.05）。面神经麻痹分级与病程均与睑板腺功能障碍呈显著相关（P<0.05）。研究结论：睑板腺功能障碍在面神经麻痹后干眼症的发病过程中发挥显著作用；同时，面神经麻痹分级与病程均与睑板腺功能障碍存在较强相关性。