Dry eye is a multifactorial and common age-related ocular surface disease. Dyslipidemia has been reported to be involved in meibomian gland dysfunction (MGD). However, it has not been clearly identified which lipid abnormality is responsible for MGD. In this systematic review and meta-analysis, we discuss how lipid profile changes with aging is responsible for MGD development. Methods. An article search was performed in PubMed, EMBASE, and Web of Science. Eleven studies involving dyslipidemia in patients with MGD were identified. Five out of eleven studies were further analyzed with meta-analysis. The preferred reporting items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were followed. Study-specific estimates (prevalence of dyslipidemia in MGD patients) were combined using one-group meta-analysis in a random-effects model. Results. Meta-analysis revealed that high total cholesterol (TC) and high triglycerides (TG) were significantly associated with MGD prevalence, with odds ratios of 5.245 (95% confidence interval [CI]: 1.582–17.389; p < 0.001) and 3.264 (95% CI: 1.047–10.181; p < 0.001), respectively, but high low-density lipoprotein (LDL) and low high-density lipoprotein (HDL) were not identified. Systematic review found that the percentage of MGD patients with TC ≥ 200 mg/dL ranged from 20.0–77.6%, TG ≥ 150 mg/dL ranged from 8.3–89.7%, whereas, in the aged-match-adjusted controls, TC range of 200 mg/dL or higher and TG range of 150 mg/dL was 6.1–45.1% and 1.1–47.8%, respectively. The severity of MGD was higher with dyslipidemia. Conclusion. Dyslipidemia and higher TC and TG are significant risk factors for MGD.

Purpose: To report the efficacy and safety of mature cultured corneal endothelial cell (CEC) transplantation using neltependocel combined with the Rho kinase inhibitor Y-27632 (Vyznova) in eyes with declining long-term efficacy after transplantation of immature cultured CECs (prototype cells). Methods: In the first-in-human CEC therapy study conducted in 2014, 2 patients (#4 and #11) who received prototype cultured CEC initially demonstrated restoration of corneal transparency, but the patients' endothelial function deteriorated after several years. These 2 patients were later treated with Vyznova in 2024. Clinical outcomes assessed included corneal thickness, CEC density, best-corrected visual acuity (BCVA), and intraocular pressure. Results: In patient 4 (pseudoexfoliation syndrome), corneal thickness improved from 786 to 572 μm, and CEC density was 2292 cells/mm ² at 1 year postoperatively. BCVA improved from 0.03 to 0.4 (decimal visual acuity). In patient 11 (Fuchs endothelial corneal dystrophy), corneal thickness improved from 688 to 523 μm, and CEC density was 2552 cells/mm ² at 1 year postoperatively. BCVA improved from 0.07 to 1.0 (decimal visual acuity). Neither case exhibited graft rejection, elevated intraocular pressure, or anterior uveitis. Conclusions: Administration of Vyznova was safe and demonstrated favorable clinical outcomes in eyes with declining long-term efficacy after initial treatment with prototype CECs. These findings support the feasibility of Vyznova as a treatment strategy for corneal endothelial failure in patients previously treated with cultured CECs.