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The effect of heat treatment on Meibomian Gland Dysfunction

Srihari Narayanan, Sandra Fortenberry, Narges Kasraie, Charles G Connor

Objective: Meibomian gland dysfunction (MGD) is the most common cause of dry eye disease (DED). Though manual warm compresses (WC) are the backbone of managing MGD, poor compliance makes an office-based procedure desirable. This paper compares WC to MiBoFlo and the heated eye pad. MiBoFlo uses a thermoelectric heat pump to deliver a constant level of heat through an ultrasound gel. Digital Heat Inc developed an electric powered Heated Eye Pad (HEP) designed to warm the Meibomian sebum. The HEP resembles a spectacle frame.

Methods: Sixty subjects with MGD were randomly divided into three treatment groups after collection of baseline data. Baseline data included Ocular Surface Disease Index (OSDI), Tear Break-up time (TBUT) and Efron grading of MGD and blepharitis. The same data were collected 4 weeks after treatment. The first group was the warm compress group, the second group the MiBoFlo group and the third group the heated eye pad.

Results: Only the warm compress group showed statistically significant reduction in dry eye symptoms by OSDI (p=0.015) but the other two techniques did reduce symptoms from baseline. None of the techniques improved TBUT from baseline in a statistically significant manner. The MiBoFlo was the only treatment that resulted in a statistically significant change from baseline in Efron grading of both MGD (p=0.01) and blepharitis (p=0.01).

Conclusion: Our data suggests that MiBoFlo and the heated eye pad may be suitable alternatives to WC to achieve greater patient compliance.