Acta Scientific Ophthalmology (ISSN: 2582-3191)

Review Article Volume 4 Issue 5

Current treatments for Meibomian Gland Dysfunction and Eye Lid Margin Disease

Karl Stonecipher*, Kody Stonecipher, Megan Stonecipher and Brent Kramer

Physicians Protocol, Greensboro, North Carolina, USA

*Corresponding Author: Karl Stonecipher, Physicians Protocol Greensboro, North Carolina, USA.

Received: March 11, 2021; Published: April 01, 2021

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Abstract

Importance: This study highlights the value of current therapeutic devices in the authors practice for the management of meibomian gland dysfunction (MGD) and eyelid margin disease (ELD).

Background: To evaluate the effects of current therapeutic devices on clinical measures of dry eye related to MGD and ELD in patients unresponsive to previous therapies.

Design: A retrospective chart review of patients treated at one site.

Participants: One thousand three hundred eighty-six eyes of 711 treated patients who were documented treatment failures with previous pharmaceuticals and/or devices were included in the patient population.

Methods: Treatments for MGD included: lid exfoliation, low level light therapy in combination or alone with intense pulsed light therapy (LLLT or LLLT/IPL), thermal pulsation, blink assisted thermal energy, and radiofrequency thermal energy all performed at one center.

Main Outcome Measures: Results included changes in the graded MGD score (grading scale 0 - 4), tear breakup time (TBUT), Ocular Surface Disease Index (OSDI) questionnaire score and lissamine green staining (LGS).

Results: Significant improvements in the MGD scores, TBUT, OSDI questionnaire scores and LGS were seen. There were no ocular or facial adverse events or side effects related to any of the treatments.

Conclusion: The application of an algorithm for the treatment of MGD and ELD is beneficial in the majority of patients who had failed to improve with alternative pharmaceutical and device interventions.

Keywords: Low Level Light Therapy (LLLT); Intense Pulsed Light (IPL); Meibomian Gland Dysfunction; Ocular Surface Disease Index (OSDI); Dry Eye Disease (DED); Eye Lid Margin Disease

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References

  1. Mathers WD. “Ocular evaporation in meibomian gland dysfunction and dry eye”. Ophthalmology3 (1993): 347-351.
  2. Craig JP., et al. “TFOS DEWS II Report Executive Summary”. The Ocular Surface 4 (2017): 802-812.
  3. Nichols KK., et al. “The international workshop on meibomian gland dysfunction: executive summary”. Investigative Ophthalmology and Visual Science 4 (2011): 1922-1929.
  4. Nichols JJ., et al. “TFOS DEWS II Definition and Classification Report”. The Ocular Surface 3 (2017): 276-283.
  5. Milner M., et al. “Dysfunctional Tear Syndrome: An Innovative and Practical Approach to Diagnosis and Treatment”. Current Opinion in Ophthalmology 1 (2017): 3-47.
  6. Shen Lee B., et al. “Managing Dry Eye Disease and Facilitating Realistic Patient Expectations: A Review and Appraisal of Current Therapies”. Clinical Ophthalmology 14 (2020): 119-126.
  7. Matossian C., et al. “Dry Eye Disease: Consideration for Women's Health”. Journal of Women's Health 4 (2019): 502-514.
  8. Gupta PK., et al. “Prevalence of Meibomian Gland Atrophy in a Pediatric Population”. Cornea4 (2018): 426-430.
  9. Sharma DP., et al. “Microbial keratitis after corneal laser refractive surgery”. Future Microbiology 7 (2011): 819-831.
  10. Grzybowski A., et al. “Endophthalmitis Prophylaxis in Cataract Surgery: Overview of Current Practice Patterns Around the World”. Current Pharmaceutical Design 4 (2017): 565-573.
  11. Garg Prashant., et al. “Endophthalmitis after cataract surgery”. Current Opinion in Ophthalmology1 (2017): 67-72.
  12. Stonecipher MK and Stonecipher KG. “Influences on enhancement rates in laser vision correction”. US Ophthalmic Review2 (2016): 2-4.
  13. Schanlzin D., et al. “Efficiacy of self-administration of a personal mechanical eyelid device for the treatment of drye eye disease, blepharitis and meibomian gland disease”. Dry Eye Ocular Surface Disease 1 (2020): e1-e5.
  14. Epstein IJ., et al. “Double-Masked and Unmasked Prospective Study of Terpinen-4-ol Lid Scrubs With Microblepharoexfoliation for the Treatment of Demodex Blepharitis”. Cornea4 (2020): 408-416.
  15. Stonecipher K and Potvin R. “Low level light therapy for the treatment of recalcitrant chalazia: a sample case summary”. Clinical Ophthalmology 13 (2019): 1727-1733.
  16. Verbelli M., et al. “Dry eye in patient with clinical history of chronic blepharitis and chalaziosis: Observation and anamnesis Eye Doctor 2 (2018): 4-6.
  17. Karu T. “Primary and secondary mechanisms of action of visible to near-IR radiation cells”. The Journal of Photochemistry and Photobiology B 1 (1999): 1-17.
  18. Eellls J., et al. “Photobiomodulation for the treatment of retinal injury and retinal degenerative diseases”. In: Waynant RW, Tata DB; editors. Proceeding of Light-Activated Tissue Regeneration and Therapy Conference. New York, NY: Springer Science (2008): 39-51.
  19. Terada O., et al. “Ocular surface temperature of meibomian gland dysfunction patients and the melting point of meibomian gland secretions”. Nippon Ganka Gakkai Zasshi 108 (2004): 690-693.
  20. Olson MC., et al. “Increase in tear film lipid layer thickness following treatment with warm compresses in patients with meibomian gland dysfunction”. Eye Contact Lens 29 (2003): 96-99.
  21. Pult H. “Low-Level Light Therapy in the Treatment of Meibomian Gland Dysfunction”. Investigative Ophthalmology and Visual Science7 (2020): 99.
  22. Stonecipher KG., et al. “Low Level Light Therapy for Meibomian Gland Dysfunction”. Acta Scientific Ophthalmology11 (2020): 13-18.
  23. Tashbayev B., et al. “Intense pulsed light treatment in meibomian gland dysfunction: A concise review”. The Ocular Surface 4 (2020): 583-594.
  24. Toyos R., et al. “Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retro-spective study”. Photomedicine and Laser Surgery 1 (2015): 41-46.
  25. Craig JP., et al. “Prospective trial of intense pulsed light for the treatment of meibomian gland dysfunction”. Investigative Ophthalmology and Visual Science 3 (2015): 1965-1970.
  26. Yin Y., et al. “Changes in the meibomian gland after exposure to intense pulsed light in meibomian gland dysfunction (MGD) patients”. Current Eye Research 3 (2018): 308-313.
  27. Arita R., et al. “Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction”. The Ocular Surface 1 (2019): 104-110.
  28. Dell SJ., et al. “Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction”. Clinical Ophthalmology 11 (2017): 817-827.
  29. Dell SJ. “Intense pulsed light for evaporative dry eye disease”. Clinical Ophthalmology 11 (2017): 1167-1173.
  30. Stonecipher K., et al. “Combined low level light therapy and intense pulsed light therapy for the treatment of meibomian gland dysfunction”. Clinical Ophthalmology13 (2019): 993-999.
  31. Lemp MA., et al. “Distribution of Aqueous-Deficient and Evaporative Dry Eye in a Clinic-Based Patient Cohort”. Cornea5 (2012): 472-478.
  32. Blackie CA., et al. “The sustained effect (12 months) of a single-dose vectored thermal pulsation procedure for meibomian gland dysfunction and evaporative dry eye”. Clinical Ophthalmology 10 (2016): 1385-1396.
  33. Lane SS., et al. “A New System, the LipiFlow®, for the Treatment of Meibomian Gland Dysfunction (MGD)”. Cornea4 (2012): 396-404.
  34. Blackie C., et al. “Treatment for meibomian gland dysfunction and dry eye symptoms with a single-dose vectored thermal pulsation: a review”. Current Opinion in Ophthalmology4 (2015): 306-313.
  35. Tauber J., et al. “Comparison of the iLUX and the LipiFlow for the Treatment of Meibomian Gland Dysfunction and Symptoms: A Randomized Clinical Trial”. Clinical Ophthalmology 14 (2020): 405-418.
  36. “RF science and safety: Cynosure radio frequency devices (2020).
  37. Trattler WB., et al. “The Prospective Health Assessment of Cataract Patients’ Ocular Surface (PHACO) study: the effect of dry eye”. Clinical Ophthalmology 11 (2017): 1423-1430.
  38. Donaldson K., et al. “Perioperative assessment for refractive cataract surgery”. Journal of Cataract and Refractive Surgery 5 (2018): 642-653.
  39. Kieval JZ., et al. “Prevention and management of refractive prediction errors following cataract surgery”. Journal of Cataract and Refractive Surgery 8 (2020): 1189-1197.
  40. Stonecipher KG., et al. “The IMPACT Study: A prospective evaluation of the effects of cyclosporine 0.05% ophthalmic emulsion on ocular surface staining and visual performance in patients with dry eye”. Clinical Ophthalmology (2016).
  41. Stonecipher K., et al. “Efficacy and safety of topical cyclosporine in dry eye subjects who engage in electronic visual tasking-The EMPOWER study”. US Ophthalmic Review2 (2019): 88-95.
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Citation

Citation: Karl Stonecipher., et al. “Current treatments for Meibomian Gland Dysfunction and Eye Lid Margin Disease".Acta Scientific Ophthalmology 4.5 (2021):19-24 .




Metrics

Acceptance rate35%
Acceptance to publication20-30 days
ISI- IF1.042
JCR- IF0.24

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