A Novel Thermodynamic Treatment for Meibomian Gland Dysfunction

Abstract

Purpose: To evaluate a novel thermodynamic treatment for obstructive meibomian gland dysfunction (MGD).

Materials and Methods: Fourteen adult subjects (10 females, 4 males, mean age = 54.2 ± 9.6 yr) were recruited in a multi-center, feasibility clinical trial in Durham and Cary, North Carolina and Boston, Massachusetts. Inclusion criteria included: previous diagnosis of moderate to severe dry eye; dry eye symptoms for at least three months prior; daily topical lubricant use; and evidence of meibomian gland (MG) obstruction in the central five glands of both eyes lower eyelids. Exclusion criteria included: history of recent acute or chronic ocular inflammation or infection and lid surface abnormalities affecting lid function. The treatment: the device heats the palpebral surface of upper and lower eyelids while simultaneously applying graded pulsatile pressure to the outer eyelid for 12 min, thereby expressing the MGs during heating. One eye was randomly selected to undergo additional manual heated expression with another treatment device.

Results: The mean MG secretion score, tear break-up time, corneal staining score, number of MGs yielding liquid secretion and symptom scores all improved significantly from baseline to 1 week. This was maintained through the 3-month follow-up. There was no statistically significant difference in any outcome between the automated device treatment only and the additional heated manual expression.

Conclusion: The combination of heat applied to the palpebral surface, while simultaneously expressing MGs during a single 12-minute treatment, was effective, in this feasibility study, in treating obstructive MG dysfunction and dry eye signs and symptoms for the 3-month study period.

KEYWORDS::

• Heated meibomian gland expression
• Meibomian gland dysfunction
• Obstructive meibomian gland dysfunction
• Thermodynamic MGD treatment
• Treatment for MGD and dry eye

ACKNOWLEDGMENTS

The authors would like to acknowledge Korb Associates, Boston, MA and TearScience, Morrisville, NC for financial support. The authors would also like to thank Raman Bedi, M.D., Stephen Grenon, M.E., and Christy Stevens, O.D. for their valuable contributions to the manuscript.

Declaration of interest: BRF, CPF, and DRK are consultants for TearScience; CAB is an employee of TearScience.