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. 2025 Oct 10;25(1):560.
doi: 10.1186/s12886-025-04378-0.

Analysis of risk factors associated with meibomian gland orifice obstruction severity in glaucoma patients: a clinical investigation

Yue Tan  1   2   3 , Yue Yin  4   5   6 , Wushuang Wang  1   2   3 , Tong Lin  7   8   9 , Lan Gong  10   11   12
Affiliations

Analysis of risk factors associated with meibomian gland orifice obstruction severity in glaucoma patients: a clinical investigation

Yue Tan et al. BMC Ophthalmol. .

Abstract

Purpose: To investigate the synergistic effects of duration of glaucoma and number of medications on meibomian gland orifice obstruction severity in glaucoma patients, aiming to optimize therapeutic strategies for ocular surface protection.

Methods: This retrospective study analyzed 120 glaucoma patients with concurrent MGD. Meibomian gland orifice obstruction was scored using standardized criteria. The relationship between obstruction scores and clinical factors was evaluated using Spearman correlation and generalized linear modeling.

Results: Significant correlations were found between MG orifice obstruction score and duration of glaucoma (r = 0.309, P < 0.001), number of medications (r = 0.340, P < 0.001), number of preserved eye drop products (r = 0.300, P < 0.001) and duration of medication (r = 0.398, P < 0.001). Generalized linear modeling revealed significant main effects of duration of glaucoma and number of medications (P = 0.012 and P = 0.005), with a significant interaction (P = 0.020). After 3 years of glaucoma, any medication regimen significantly increased obstruction scores compared to no treatment (all P < 0.05). Triple or quadruple therapy showed significantly higher obstruction scores versus no medication (P = 0.002 and P = 0.008).

Conclusion: Duration of glaucoma and number of medications synergistically worsen MG orifice obstruction, with a critical threshold after one year of disease. These findings suggest the importance of reducing medication burden in long-term glaucoma patients.

Keywords: Duration of glaucoma; Glaucoma; Meibomian gland dysfunction; Number of medications; Orifice obstruction.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol adhered to the tenets of the Declaration of Helsinki and received approval from the Ethics Committee of the Eye & ENT Hospital of Fudan University. The requirement for informed consent was waived due to the retrospective nature of the study. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of Anti-Glaucoma Medication Regimens.Categorical representation of medication patterns (n = 120). None: unmedicated; A: α-adrenergic agonists; B: β-blockers; C: carbonic anhydrase inhibitors; PG: prostaglandin analogues; M: pilocarpine. Numbers indicate patient count in each category.
Fig. 2
Fig. 2
Representative Clinical Features of MGD in Glaucoma Patients. A Mild MGD in a patient with angle-closure glaucoma maintaining adequate IOP control post-LPI without medications. B Severe MGD in a patient receiving quadruple therapy, showing eyelid margin hyperemia, MG orifice obstruction, and inferior corneal epithelial damage (indicated by arrow).
Fig. 3
Fig. 3
Effects of the duration of glaucoma and the number of medications on the degree of MG orifice obstruction in the generalized linear model (GLM). (A) The interaction between the duration of glaucoma history and the number of medications. (B) The individual effect of glaucoma history duration. (C) The individual effect of the number of medications. The figure displays the estimating marginal means with 95% confidence intervals
See this image and copyright information in PMC

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