Early And Stepwise Improvement In Meibomian Gland Dysfunction After Tixel I Therapy: A Prospective Multicenter Real-World Study
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR489 | Type: Free paper | DOI: 10.82333/ys1x-pj02
Authors: Dr Ifat Klein 1 , Dr Andrew Mackelprang 2 , Dr Mark Cannon 3 , Dr Ted Loizos 4 , Dr Lauren Bailey 5 , Dr Chris Carpenter 6 , Dr Neil Notaroberto 7 , Dr Lauren Foley 8 , Dr Naoman Sanni 9 , Dr ludger Hanneken* 10 , Dr Ehud Reich 11
1industry,ranana,Israel, 2Oro Valley Eyecare,Oro Valley AZ,United States, 3Cannon EyeCare ,Seattle, WA ,United States, 4Fairview Eye Center, Inc. ,Fairview Park, OH,United States, 5West Plano Dry Eye,Plano, TX,United States, 6Seville Eye Center,Gilbert, AZ ,United States, 7EyeCare 20/20 Retina & Vision Center,Metairie - Mandeville – Slidell,United States, 8Eyes of North Scottsdale,Scottsdale, AZ,United States, 9Center For Sight,Watertown, NY,United States, 10Fontaneda 3, 5A,Sant Julia,Andorra, 11Ophthalmology,Shaare Zedek Medical Center,jerusalem ,Israel
Purpose
To evaluate early and short-term clinical outcomes and safety of Tixel i therapy in patients with meibomian gland dysfunction (MGD)–related dry eye in a real-world setting.
Setting
Prospective, multicenter, observational real-world evidence study conducted across eight clinics in the United States under IRB-exempt status.
Methods
Eighty-two subjects (mean age 60.0±14.9 years; 82.9% female) with predominantly moderate–severe MGD (85.4%) and long-standing symptoms (>2 years in 79.3%) were enrolled. Subjects received three Tixel i treatments at two-week intervals according to the user manual. Data were collected anonymously using a standardized questionnaire. Analyses were performed using subject-level averages of both eyes. Outcomes included OSDI, tear break-up time (TBUT), and meibomian gland secretion score (MGSS), assessed at baseline, after one treatment (pre-Tx2), after two treatments (pre-Tx3), and at 4 weeks. Safety was assessed by collection of adverse events (AEs). Patient and physician satisfaction were evaluated at 4 weeks.
Results
Significant improvement was observed after a single treatment, with reductions in symptoms (OSDI −7.6±15.7 points) and improvements in tear stability (TBUT +2.3±3.3 s) and gland function (MGSS +6.2±6.8) (all p<0.001). Further stepwise improvement occurred after two treatments and at 4 weeks, with maximal effects at 4 weeks (OSDI −20.9±18.2; TBUT +3.3±3.4 s; MGSS +11.6±9.4; all p<0.001). Higher baseline MGSS correlated with greater proportional improvement at 4 weeks. Patient and physician satisfaction scores at 4 weeks were high and aligned with symptom improvement. Seventeen adverse events were reported; all were mild, expected, transient, and resolved within a short period without medical intervention.
Conclusions
In a predominantly chronic, moderate–severe MGD population, Tixel i therapy demonstrated rapid onset of clinically meaningful benefit after a single treatment, with cumulative improvement through 4 weeks. The treatment was well tolerated, with a favorable safety profile in real-world clinical practice.