The Effect Of Thermo-Mechanical Device (Tixel) Treatment On Evaporative Dry Eye Disease - A Prospective Clinical Trial

To examine the effects of treatment with a thermomechanical skin device (Tixel) to the eyelid area on patients who suffer from dry eye disease (DED) secondary to meibomian gland dysfunction (MGD).

Department of Ophthalmology of a public hospital in Israel, Shamir Medical Center

In this prospective clinical trial patients aged 45 years or older with DED due to MGD were recruited. Eighty eyes of 40 patients received three treatments with the Tixel device (Novoxel®, Israel) across the upper and lower eyelids at constant intensity, tip protrusion distance, and contact duration every two weeks. Two additional follow-up visits were performed at 2-week intervals after treatment cessation. DED status was evaluated during each visit via SPEED II questionnaire, tear break-up time (TBUT), corneal staining score (CSS), MGD score, and frequency of lubricant use. Visual acuity (VA) was recorded during first and last visits.

Mean age was 64.3±12.4 years and 72.5% (n=29) were female. 45% (n=18) had a history of blepharitis, 12.5% (n=5) had chalazia, and 17.5% (n=7) suffered from allergic conjunctivitis. Mean follow-up time was 2.1±0.57 months. Comparing the first and last visits, all parameters showed significant improvement after Tixel treatment: mean SPEED II scores (16.45±5.85 to 11.8±6.66, p<0.01), CSS (1.98±1.25 to 0.50±0.91, p<0.01), TBUT (2.70±0.80 seconds to 6.50±2.16 seconds, p<0.01), MGD score (2.65±0.50 to 1.23±0.41, p<0.01), and rate of lubricant use (3.40±2.40 per day to 1.85±2.02, p<0.01). VA also improved (0.10±0.11 LogMAR to 0.08±0.10 LogMAR, p<0.05). No major side effects were observed.

Among patients with DED due to MGD, Tixel treatment induced significant improvement of signs and symptoms. Benefits persisted for at least one month.