The optimum temperature for the heat therapy for meibomian gland dysfunction

Borchman, Douglas

doi:10.1016/j.jtos.2019.02.005

Cited by 53 publications

(51 citation statements)

References 52 publications

(58 reference statements)

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“…Treatment of blepharitis and MGD includes eyelid hygiene, warm compress, and topical and systemic antibiotic therapy 14 – 17 . Warm compress is conducted to heat the eyelid above the phase transition temperature of meibum which results in more meibum delivery to the eyelid 18 . Eyelid hygiene is reported to be particularly effective in eliminating waste products such as crusts, waxy meibum, and bacterial lipase in the eyelids and improving symptoms of anterior and posterior blepharitis 19 – 22 .…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of eyelid hygiene in blepharitis and meibomian gland dysfunction after cataract surgery: a randomized controlled pilot trial

Eom

Hwang

et al. 2020

Sci Rep

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The purpose of this randomized clinical trial is to evaluate the effect of eyelid hygiene on subjective symptoms, anterior blepharitis, and meibomian gland dysfunction (MGD) after cataract surgery. Subjects with obstructive MGD who underwent cataract surgery were randomly divided into two groups. In the eyelid hygiene group, eyelid hygiene was performed twice a day for 10 days from 3 days before to 1 week after cataract surgery. The control group did not perform eyelid hygiene. A subjective symptom questionnaire of SPEED, anterior blepharitis grade, and meibum quality and quantity was evaluated at baseline and at postoperative 1 and 4 weeks. The eyelid hygiene group (n = 36) showed decreased SPEED score after cataract surgery and the control group (n = 33) did not. Anterior blepharitis grade was worse 1 week after surgery in the control group but not in the eyelid hygiene group. The control group had significantly decreased meibum quality and quantity in both the upper and lower eyelids after cataract surgery, but the eyelid hygiene group did not. Eyelid hygiene before/ after cataract surgery improved postoperative subjective symptoms and prevented postoperative exacerbation of anterior blepharitis and MGD. Thus, perioperative eyelid hygiene is recommended for patients with obstructive MGD who undergo cataract surgery. Blepharitis is divided into anterior and posterior blepharitis according to anatomic location. Meibomian gland dysfunction (MGD) is the main cause of posterior blepharitis. MGD is characterized by abnormal meibomian gland secretion, qualitative/quantitative changes in meibum, dry eye symptoms, and ocular surface inflammation 1-3. Anterior blepharitis and MGD are important factors that may cause evaporative dry eye syndrome 4,5. They cause deficiency or imbalance of the tear film lipid layer secreted from meibomian glands to increase tear evaporation even if aqueous tear secretion is normal 6,7. On the other hand, another study reported that the tear film lipid layer itself may not inhibit the rate of tear evaporation 8. Nevertheless, an important function of the tear film lipid layer is to spread tears to the ocular surface between blinks, helping to maintain tear film homeostasis on the ocular surface. Previous studies have reported that the signs of blepharitis can worsen after cataract surgery, and the degree of dry eye syndrome and MGD is worse than before surgery 9-12. More significant worsening of MGD was observed

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Section: Introductionmentioning

confidence: 99%

Clinical efficacy of eyelid hygiene in blepharitis and meibomian gland dysfunction after cataract surgery: a randomized controlled pilot trial

Eom

Hwang

et al. 2020

Sci Rep

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“…In this review, the objective measurement included gland function, tear break up time (TBUT), the Schirmer test, tear osmolarity, lipid layer thickness, whereas the subjective measurement was based on the Ocular Surface Disease Index [79]. Different heated devices have been developed to warm the eyelid as a therapy for Meibomian gland dysfunction treatment, Borchman D reveals that the safety and tolerable temperature for heating the eyelide not to cause the disorder of Meibomian gland should be between 30-34 • C for warm treatment [80].…”

Section: Lipid Anomaly Dry Eye (Lade)mentioning

confidence: 99%

“…Elevated eyelid temperature delivers more meibomian oil to the eyelid [165], and it is a way to ameliorate dry eye symptoms by warm treatment. However, too high a temperature should be avoided as heat could cause injury to the eyelid skin, and also contribute to presbyopia and cataract [80,166]. Borchman D proved that heating the eyelid above the phase transition temperature (Tt) of meibum, which is 30-34 • C, can slightly increase the disorder of meibum lipid to ameliorate dry eye symptoms [80].…”

Section: Warm Compressionmentioning

confidence: 99%

“…However, too high a temperature should be avoided as heat could cause injury to the eyelid skin, and also contribute to presbyopia and cataract [80,166]. Borchman D proved that heating the eyelid above the phase transition temperature (Tt) of meibum, which is 30-34 • C, can slightly increase the disorder of meibum lipid to ameliorate dry eye symptoms [80]. At higher tehperature (>40 • C), the heat could cause Meibomian gland dysfunction reach up to 90%.…”

Section: Warm Compressionmentioning

confidence: 99%

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Dry Eye Disease: A Review of Epidemiology in Taiwan, and its Clinical Treatment and Merits

Kuo

Lin

Chien

et al. 2019

JCM

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Dry eye disease (DED) has become common on a global scale in recent years. There is a wide prevalence of DED in different countries based on various ethnicities and environment. DED is a multifactorial ocular disorder. In addition to advanced age and gender, such factors as living at high altitude, smoking, pterygium, prolonged use of consumer electronics or overingesting of caffeine or multivitamins are considered to be the major risk factors of DED. We report the DED epidemiology in Taiwan firstly in this article. According to the pathophysiological factors and changes inthe composition of the tear film in DED, it can be categorized into several subtypes, including lipid anomaly dry eye, aqueous tear deficiency, allergic and toxic dry eye among others. Each subtype has its own cause and disease management; therefore, it is important for ophthalmologists to identify the type through literature review and investigation. The management of DED, relies not only on traditional medications such as artificial tears, gels and ointments, but also newer treatment options such as acupuncture, SYL1001, and nanomedicine therapy. We also conducted a comprehensive literature review including common subtypes and treatment of DED. Clearly, more clinical trials are needed to assess the efficacy and safety of the various treatments and common subtypes of DED.

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“…Meibum from donors who have had HSCT (M HSCT ) have the highest order of all of the samples measured [ [12] , [13] , [14] , [15] ] and the donors are very susceptible to severe dry eye symptoms [ [16] , [17] , [18] , [19] , [20] , [21] ]. In a recent study [ 15 ], tear lipids (TL HSCT ) and meibum (M HSCT ) from patients who had HSCT were pooled prospectively.…”

Section: Introductionmentioning

confidence: 99%

Meibum lipid hydrocarbon chain branching and rheology after hematopoietic stem cell transplantation

Mudgil

Ramasubramanian

Borchman

2020

Biochemistry and Biophysics Reports

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Purpose Meibum from donors who have had hematological stem cell transplantations (M HSCT ) are susceptible to severe dry eye symptoms and exhibit very high lipid order (stiffness) compared with meibum from donors without dry eye (M n ). Since lipid order could have functional consequences, we compared the rheology and composition of M n and M HSCT to measure meibum compositional, structural and functional relationships. Methods The rheology and composition was measured using Langmuir trough and 1 H NMR spectroscopy, respectively. Results M HSCT and M n was studied from 16 to 43 donors, respectively, using NMR spectroscopy. M HSCT contained significantly 16% more straight chain and 24% less iso-chain hydrocarbons compared with M n . The cholesteryl ester to wax ester molar ratio, and hydrocarbon chain unsaturation were not significantly different, for M HSCT compared with M n . Surface pressure-area isotherms of meibum from 30 donors without dry-eye were grouped into 4 pools (PC) and meibum from 32 donors with dry eye who had hematopoietic stem cell transplantation (PT) were grouped into 3 pools. Above 15 years of age the П max and (C s −1 ) max increased with age for both the PC and the PT cohorts. (C s −1 ) max values were higher for PT samples compared with age matched PC samples, indicating they had higher elasticity and stiffness. A more ordered lipid could contribute to the formation of a discontinuous patchy tear film lipid layer, which in turn results in deteriorated spreading, and decreased surface elasticity. Conclusions The composition and rheology of meibum from donors with dry eye and who have had HSCT support the idea from other studies that more ordered meibum may contribute to or be a marker of dry eye.

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The optimum temperature for the heat therapy for meibomian gland dysfunction

Cited by 53 publications

References 52 publications

Clinical efficacy of eyelid hygiene in blepharitis and meibomian gland dysfunction after cataract surgery: a randomized controlled pilot trial

Clinical efficacy of eyelid hygiene in blepharitis and meibomian gland dysfunction after cataract surgery: a randomized controlled pilot trial

Dry Eye Disease: A Review of Epidemiology in Taiwan, and its Clinical Treatment and Merits

Meibum lipid hydrocarbon chain branching and rheology after hematopoietic stem cell transplantation

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