Comparative Analysis of Meibomian Gland Dysfunction in Eyes with and without Eyelid Margin Tattoos
Ma. Joanna Carla Z. Garcia, MD1, Edgar U. Leuenberger, MD, DPBO1,2, James Paul S. Gomez, MD, DPBO2, Tommee Lynne T. Tiu, MD, DPBO1,3,4,5, Sharlene I. Noguera, MD, DPBO2
1Department of Ophthalmology, University of the East Ramon Magsaysay Medical Center, Quezon City, Philippines
2Asian Eye Institute, Makati City, Philippines
3Eye Institute, St. Luke’s Medical Center, Quezon City, Philippines
4Clinica Tamesis, Quezon City, Philippines
5Department of Ophthalmology, New Era General Hospital, Quezon City, Philippines
Correspondence: Ma. Joanna Carla Z. Garcia, MD
Department of Ophthalmology, 5th floor Charity Bldg., 64 Aurora Boulevard
Barangay Doña Imelda, Quezon City
Disclosure: The authors report no conflict of interest.
Objective: To compare the presence and severity of meibomian gland (MG) dysfunction among eyes of female subjects with and without eyelid margin tattoos using infrared meibography and colored photographs.
Methods: This is a cross-sectional, descriptive study that involved 38 Filipino females with and without eyelid margin tattoos. Infrared meibography was performed on the upper and lower eyelids of each eye to assess total or partial MG dropout. Colored photographs were taken to evaluate vascularity, irregularity, thickening of the lid margins, and plugging of MG orifices. Severity of MG dysfunction (MGD) was assessed using Arita’s MGD proposed grading scale. Independent t-test was used to compare MG dropout and other lid margin parameters between the two groups. Prevalence ratio and prevalence odds ratio were calculated to measure the likelihood of MGD among eyes with eyelid tattoos.
Results: Seventy-four (74) eyes were included in the study (36 in the tattoo group and 38 in the control group). Scores for abnormal vascularity, irregularity, and thickening of the lid margins were significantly higher in the tattoo group compared to the control group (p<0.0000001). However, plugging of gland orifices scores between the two groups were found to be similar (upper eyelid: p=0.65; lower eyelid: p=0.91). Total MG dropout was significantly greater in the tattoo group (upper eyelid: -1.11 ± 0.82; lower eyelid: 1.37 ± 0.75) compared to the control group (upper eyelid: 0.53 ± 0.83; lower eyelid: 0.45 ± 0.76) (upper eyelid: p=0.003; lower eyelid: p=0.000001) for the upper and lower eyelid, respectively). Analysis of total MG dropout between the two groups showed a prevalence ratio of 2.13.
Conclusion: Eyelid margin tattoos are associated with several eyelid margin abnormalities and increase the risk of meibomian gland droupout.
Keywords: meibomian gland dysfunction, eyelid margin tattoos, infrared meibography