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Review
. 2020 Dec;68(12):2663-2669.
doi: 10.4103/ijo.IJO_2465_20.

A review of meibography for a refractive surgeon

Krishna Poojita Vunnava  1 , Naren Shetty  2 , Kamal B Kapur  3
Affiliations
Review

A review of meibography for a refractive surgeon

Krishna Poojita Vunnava et al. Indian J Ophthalmol. 2020 Dec.

Abstract

Refractive surgery has evolved from being a therapeutic correction of high refractive errors to a cosmetic correction. The expectations associated with such a surgery are enormous and one has to anticipate all possible complications and side-effects that come with the procedure and prepare accordingly. The most common amongst these is post-refractive surgery dry eye of which Meibomian gland dysfunction is a commonly associated cause. We present an understanding of various diagnostic imaging modalities that can be used for evaluating meibomian glands which can also serve as a visual aid for patient understanding. We also describe various common conditions which can silently cause changes in the gland architecture and function which are to be considered and evaluated for.

Keywords: Dry eye disease; meibography; meibomian gland dysfunction.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Image from In vivo laser confocal microscopy of the meibomian glands (42 μm using Heidelberg Retina Tomograph II-Rostock Cornea Module; Heidelberg Engineering GmbH, Dossenheim, Germany) showing glandular fibrosis
Figure 2
Figure 2
Contrast enhanced (a) and regular (b) image of upper lid taken on Oculus Keratograph® 4 (Oculus Optikgerate GmBH, Germany). Bold arrow denoting increased tortuosity of the glands, dotted arrow showing the thinning noted in some glands
Figure 3
Figure 3
Contrast enhanced (a) and regular (b) image of upper lid taken on Oculus Keratograph® 4 (Oculus Optikgerate GmBH, Germany) Bold arrow showing a dilated gland noted by increased width at that cross section. Dotted arrow denoting thinning
Figure 4
Figure 4
Contrast enhanced (a) and regular (b) image of upper lid taken on Oculus Keratograph® 4 (Oculus Optikgerate GmBH, Germany) Showing huge drop outs. Such a picture is commonly seen in long term contact lens users
Figure 5
Figure 5
Image of a report generated from SBM Sistemi Idra Dry Eye Analyzer (Torino, Italy). It shows an automated gland recognition and segmentation done to calculate the drop out percentage for a more objective assessment. Note that the software can miss detecting the glands if the positioning is incorrect while taking an image
See this image and copyright information in PMC

References

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