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Background  The anticancer TS-1 ®  combination capsules of tegafur, gimeracil, and oteracil potassium (Taiho Pharmaceutical Co. Ltd, Japan) causes side effects,  i. e.,  corneal epithelial disorder and dacryostenosis. However, its side effect on meibomian gland had not been reported. We observed morphological changes in the meibomian gland in patients taking TS-1 ®  who exhibited punctate corneal epithelial defects to examine if dysfunction of meibomian glands is involved in the corneal epitheliopathy.    Case presentation  Patients comprised two males and one female (age, 59–81 years). After starting oral TS-1 ®  administration, patients developed subjective symptoms such as decreased visual acuity. Corneal epithelial disorder was seen in all six eyes of the three subjects exhibited, and lacrimal duct disorder was seen in one eye. Furthermore, meibomian gland loss and contraction were observed in all six eyes that exhibited meibomian gland disorder upon examination by using the MeiboPen ® .    Conclusions  Results suggested that oral administration of TS-1 ®  may cause meibomian gland disorder which potentially affect corneal epithelial homeostasis.

Abnormalities in the meibomian glands in patients with oral administration of anticancer combination drug-capsule TS-1®: a case report