Efficacy of Tacrolimus 0.03% Ointment in Resistant Meibomian Gland Dysfunction

Aim: To determine the efficacy of 0.03% Tacrolimus ointment in treating resistant meibomian gland dysfunction. Study design: Interventional case series. Duration and Settings of the Study: From January 2021 to June 2021 at the Department of Ophthalmology, Khyber Teaching Hospital Peshawar. Methods: Patients with meibomian gland dysfunction resistant to conventional therapy were included in the study. All of them were treated with Tacrolimus 0.03% dermatological ointment applied twice daily to eyelashes and lid margins along with lid hygiene measures. The patients were evaluated for any improvement in the subjective and objective features of the disease with therapy by conducting assessments at 2nd and 4th week of therapy and were then compared with the baseline features. Results: A total of 18 participants (36 eyes) with mean age and + standard deviation of 40 + 12.4 year participated in the study. There was no statistically significant improvement in certain parameters like inferior tear meniscus level (p=0.09), meibum quality (p=0.88), conjunctival redness (p=0.18), and telangiectasia of the lower eyelid (p=0.9). However, the fluorescein staining score (p=0.03) and telangiectasia of the upper eyelid (p=0.02) showed statistically significant improvements. As far as the subjective features of the disease were concerned, significant improvement in ocular itching (p=0.04) and dryness (p=0.03) was observed. Conclusion: Topical application of Tacrolimus 0.03% ointment showed improvement in the fluorescein staining score, telangiectasia of the upper eyelid, ocular itching and dryness in meibomian gland dysfunction in resistant cases.