Current treatments for Meibomian Gland Dysfunction and Eye Lid Margin Disease

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.