Six-month effects of a thermodynamic treatment for MGD and implications of meibomian gland atrophy.

PURPOSE: The aim of this study was to evaluate the 6-month effect of a single automated thermodynamic treatment (LipiFlow) and implications of meibomian gland atrophy on treatment efficacy 6 months after application.

METHODS: We analyzed the data of 26 subjects with meibomian gland dysfunction before and 6 months after treatment. Investigated parameters included subjective symptoms, lipid layer thickness, meibomian gland assessment, tear osmolarity, corneal and conjunctival staining, lid margin parallel conjunctival folds, Schirmer test values, bulbar redness, tear meniscus height, meibomian gland atrophy, and noninvasive tear break-up time.

RESULTS: Subjective symptoms (mean Ocular Surface Disease Index, 42 ± 19 to 33 ± 21; P = 0.004, mean Standard Patient Evaluation of Eye Dryness 16 ± 7 to 12 ± 7; P = 0.0001), lipid layer thickness (44.0 ± 15.6 to 51.3 ± 20.4; P = 0.014), number of expressible glands (2.9 ± 1.6 to 6.4 ± 4.6; P < 0.0001), lid margin parallel conjunctival folds (2.3 ± 1.0 to 2.0 ± 0.9; P = 0.04), and bulbar redness (1.4 ± 0.5 to 1.2 ± 0.5; P = 0.0001) were all improved 6 months after treatment. Symptomatic improvement was higher in patients with less severe meibomian gland atrophy compared with patients with more dropout at treatment. There was no change of meibomian gland atrophy 6 months after treatment.

CONCLUSIONS: In summary, the results showed that a single thermodynamic treatment is effective in the treatment of meibomian gland dysfunction and that the effects last for at least 6 months. We suggest performing meibography in every patient before treatment for better prediction of therapeutic effects.