Evaluation of dry eye and meibomian gland dysfunction with meibography in vitiligo.

PurposeTo evaluate the dry eye and meibomian gland dysfunction (MGD) of vitiligo patients with meibography.MethodsTwenty eyes of 20 vitiligo patients (Group 1) and 20 eyes of 20 healthy individuals (Group 2) were enrolled. All subjects had undergone a comprehensive ophthalmic examination including corneal and conjunctival fluorescein staining (Oxford scale scoring), tear film break-up time (T-BUT), Schirmer 1 test, Ocular Surface Disease Index (OSDI) score assessment, and upper and lower eyelid meibography using infrared captures of a biomicroscope (Topcon, SL-D701, IJssel, The Netherlands). Partial or complete loss of the meibomian glands was scored for each eyelid from grade 0 (no loss) through grade 3 (lost area was >2/3 of the total meibomian gland area).ResultsThe mean ages of Group 1 and Group 2 were 35.5±13.4 (range, 8-54) and 35.2±12.4 years (range, 8-52), respectively (P=0.942). Mean Schirmer 1 values were lower, and Oxford score, OSDI score, and meiboscores of lower eyelids were higher in Group 1, but the difference was not statistically significant (P=0.139, P=0.057, P=0.071, P=0.300, respectively). T-BUT values were significantly lower, and meiboscores of upper eyelids and total (upper+lower) eyelids were significantly higher in Group 1 than in Group 2 (P=0.047, P=0.001, P=0.003, respectively).ConclusionVitiligo can be associated with dry eye and there are significant differences in meibomian gland morphology in patients with vitiligo when compared with healthy subjects. For this reason, patients with vitiligo should be monitored for dry eye and MGD, and promptly start treatment when needed.

Amniotic membrane transplantation in surgical management of ocular surface squamous neoplasias: long-term results.

OBJECTIVE: To evaluate the long-term efficacy of amniotic membrane transplantation for ocular surface reconstruction in the surgical management of ocular surface squamous neoplasia (OSSN). METHODS: OSSN in 21 patients (7 female, 14 male patients) was managed with excisional biopsy, cryotherapy, corneal epitheliectomy with absolute alcohol application when the cornea is involved, lamellar sclerectomy and adjunctional absolute alcohol application to the base when episclera is involved, and ocular surface reconstruction with cryopreserved amniotic membrane transplantation. Tumor control and complications were evaluated. RESULTS: The mean age of the patients was 62.42 ± 20.9 (range, 16-84). The average diameter of the base of the tumors was 13.1 ± 4.8 (range, 9-21) mm and complete removal was achieved in all cases as revealed histopathologically. Ocular surface healing was achieved in all cases. At the postoperative period, limbal stem cell deficiency in three eyes and mild symblepharon in one eye were detected. In a mean follow-up of 30.95 ± 18.8 (range, 13-75) months, no recurrence was detected. CONCLUSION: For large or multifocal conjunctival tumors, the reconstruction of ocular surface and fornix is challenging. The amniotic-membrane use to repair conjunctival defects larger than 10 mm is a safe and effective technique with minimal complications allowing surgeons to make large enough excisions.