Comparison of Efficacy of Warm Compresses Versus Loteprednol-Tobramycin Combination Therapy in the Management of Posterior Blepharitis

Abstract

Objectives: to compare the efficacy of warm compresses to add-on therapy with Loteprednol-Tobramycin in patients withposterior Blepharitis.
 Study Design: Quasi-experimental study.
 Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Jun 2020 to Jul 2021.
 Methodology: Pre-diagnosed posterior blepharitis patients using warm compresses (Group-A) and add-on antibiotic steroid therapy (Group-B) were included in the study. A detailed history and ophthalmic examination evaluated tear breakup time, tear film height, intra-ocular pressure measurement, meibomian gland function, structure, and meibum appearance. In addition, the patient's symptoms were noted through the ocular surface disease index questionnaire. 
 Results: The study sample had seventy-one males (56%) and 55 females (43.6%) with mean age of 35.33±12.24 years. The clinical parameters in the two groups were almost alike at enrollment. There was a significant improvement in the clinical parameters in both groups. With slightly better improvement among Group-B (using Loteprednol-Tobramycin), Only two individuals did not report an increase in IOP at six weeks of treatment in Group-B. (p=0.53).
 Conclusion: Lid hygiene with warm compresses is an effective alternative with no side effects, provided if appropriately practised; however, add-on therapies may further improve MGD and Blepharitis.Keywords: Blepharitis, Meibomian gland dysfunction, Warm compresses.