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Meibomian gland dysfunction: a comparative study of modern treatments
Session Title: Special Cases
Session Date/Time: Monday 07/10/2013 | 17:00-18:30
Paper Time: 17:00
Venue: Elicium 1 (First Floor)
First Author: : A.Baumann FRANCE
Co Author(s): : B. Cochener
To evaluate a thermal pulsation treatment compared to a warming eyelid device for the management of meibomian gland dysfunction
Department of Ophtalmology, CHU Morvan, Brest, France
42 eyes of 21 patients (mean age 65,8 years) were diagnosed with meibomian gland dysfunction. The diagnosis was based on the following criteria: Results of a symptom questionnaire (Standard Patient Evaluation of Eye Dryness), quantification of the tear film lipid layer thickness using interferometric color units (ICU) measured with the Lipiview (Tearscience, Morrisville, NC), standardized meibomian gland expression to determine gland functionality. Tear Film Break Up Time, Schirmer test, osmolarity and optical quality with OQAS (MTF and OSI) were also evaluated before treatment. Patients were then randomized into two groups. One group received a 12-minute thermal pulsation treatment (Lipiflow, TearScience, Morrisville, NC). In the other group, a warming eye lid device (Meibopatch©) was applied for 5 minutes twice a day during one month. The same evaluation was performed at one month and at three months.
Results, at one month, showed a decrease in objective symptomatic relief in both groups. Further analysis shows a rehabilitation in functioning meibomian glands in the LipiFlow group at three months. Ultimately an overall higher number of functioning glands were noted in the LipiFlow group at three months. Percentage improvement will be reported on podium.
The combination of heat applied to the inner eyelid surface, together with simultaneous expression of the glands, during a single 12- minute treatment shows to be highly effective in treating cases of meibomian gland disease. Whilst results were excellent, and continued lid hygiene remains advised, the benefit of being able to simultaneous address potential compliance issues relating to ongoing treatment is significant. The convenience of a single 12-minute treatment versus an ongoing daily heating regime was shown to be highly desirable and a welcome relief in our patients busy lifestyles.