Abstract
Purpose. To investigate the safety and efficacy of monocular treatment for elderly Chinese patients with meibomian gland dysfunction (MGD) with an automated thermodynamic system. Methods. This study was a prospective, examiner-masked, contralateral eye clinical trial. The eye perceived by the patient to be worse (test eye) received a 12-minute LipiFlow treatment, while the other eye served as control. All patients were examined before treatment and one week, one month, and three months after treatment. Clinical parameters included dry eye symptoms, lipid layer thickness (LLT), partial blink (PB) ratio, invasive tear breakup time (ITBUT) and cornea staining, Schirmer I test, meibomian glands yielding liquid secretion (MGYLS), and meibomian gland dropout. Results. A total of 29 patients were examined during the three-month follow-up. At each posttreatment visit, they had a significant reduction in dry eye symptoms accompanied by an increase of ITBUT and MGYLS and a reduction in corneal staining compared with the baseline parameters. There was a significant improvement in MGYLS and ITBUT in the test eye compared with the control eye. Other clinical parameters were not statistically significant. Conclusion. LipiFlow is an effective treatment for patients with MGD. Monocular treatment with LipiFlow may be a cost-effective treatment option to those afflicted with MGD in the developing world.
Highlights
In 2011, the International Workshop on Meibomian Gland Dysfunction announced a new definition of meibomian gland dysfunction (MGD): “a chronic, diffuse abnormality of the meibomian glands, commonly characterized by terminal duct obstruction and/or qualitative/quantitative changes in the glandular secretion
There was a significant improvement in standard patient evaluation for eye dryness (SPEED) scores at the one-week visit (7.43 ± 5.18, p < 0.0001) compared with the baseline scores (11.22 ± 4.87) and this improvement was maintained at the onemonth time point (6.55 ± 5.57, p < 0.001)
Previous studies reported that a single LipiFlow 12-minute treatment improved meibomian gland secretion, Tear film breakup time (TBUT), and symptom scores at one month, nine months, 12 months, and even three years posttreatment compared with traditional or new-style warm compress therapies and common clinical methods of physical expression of meibomian gland obstruction [16]
Summary
In 2011, the International Workshop on Meibomian Gland Dysfunction announced a new definition of MGD: “a chronic, diffuse abnormality of the meibomian glands, commonly characterized by terminal duct obstruction and/or qualitative/quantitative changes in the glandular secretion. It may result in alteration of the tear film, symptoms of eye irritation, clinically apparent inflammation, and ocular surface disease [1].”. A promising new instrument called LipiFlow (TearScience Inc., Morrisville, NC) has been designed to partially or possibly completely alleviate meibomian gland obstruction This instrument combines the benefits of both heat therapy and physical expression while accurately controlling the temperature, pressure, and technique
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