Highlights
- •Meibomian gland dropout correlated with dry eye symptoms across 81 participants.
- •Randomised application of liposomal spray, latent heat goggles, or warm compresses.
- •Tear quality improved with all three therapies, independent of MGD severity.
- •Study suggests a disconnect between the mechanism of MGD and its treatment.
Abstract
Purpose
Better understanding of the pathophysiology of meibomian gland dysfunction (MGD) has
provided the opportunity to develop treatments which could be tailored for specific
presentations of MGD. This study sought to directly compare treatment effectiveness
for three current therapies across differing levels of MG dropout.
Methods
Subjects (n = 81), grouped by infrared meibography dropout proportions, into either no (control),
mild, or pronounced MG dropout, were randomised to receive treatment with a latent
heat device (n = 25), liposomal spray (n = 28), or heated warm compress (n = 28). A battery of tear film measures was performed, pre- and post-application of treatment,
and compared by treatment type and MG severity.
Results
Symptoms correlated with MG dropout proportions (r = 0.618, p < 0.001). Following treatment, non-invasive tear breakup time improved (p = 0.010), independent of treatment type (p = 0.131). The improvement was significant only in the pronounced MGD group (+4.32 ±1.15s,
p = 0.008), however, following treatment, the mild group was no longer distinct from the
control group (p = 0.843). Lipid layer grade (LLG) also improved following treatment (p < 0.009), but again was not specific to treatment type (p = 0.349). All three severity groups showed an improvement in LLG, with 49.3% of participants
showing an improvement of at least one grade, and none showing decreased LLG.
Conclusions
Increased LLG across all three treatment groups suggests that all methods increase
meibum outflow to the tear film, resulting in a thicker lipid layer after treatment.
These results suggest that all three treatments are effective in improving tear film
quality, independent of MGD severity based either on symptoms or based on gland dropout.
Keywords
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Article info
Publication history
Published online: September 30, 2017
Accepted:
September 8,
2017
Received in revised form:
August 23,
2017
Received:
July 16,
2017
Identification
Copyright
© 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
