Comparison of the therapeutic effect of Meibomian Thermal Pulsation LipiFlow® on obstructive and hyposecretory meibomian gland dysfunction patients

Li, Bowen; Fu, Hongxue; Liu, Tingting; Xu, Ming

doi:10.1007/s10792-020-01533-y

Cited by 15 publications

(10 citation statements)

References 28 publications

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“…This result was in contrast to earlier studies. [ 19 20 ] In the current study, tear osmolarity demonstrated no significant change in either group as observed in a previous study where automated thermodynamic treatment [Lipiflow®, Johnson & Johnson Inc., New Brunswick, NJ] was compared with standard lid hygiene procedure. [ 18 ] Thus, it may be inferred that LLT is a sensitive ocular surface parameter that corroborated the symptoms and signs of MGD and can serve as a useful test in monitoring the amelioration of disease with intervention.…”

Section: Discussionsupporting

confidence: 68%

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Tear film lipid layer thickness measurement from Ocular Surface Analyzer as a marker to monitor treatment of meibomian gland dysfunction in a study comparing physiological detergent-free eyelid wipes with conventional therapy: A randomized trial

Gupta

Runda

Manna

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To compare the efficacy of physiological, non-detergent eyelid wipes with conventional lid hygiene in patients with meibomian gland dysfunction (MGD). Methods: Fifty participants with MGD were recruited and randomized into two groups. Participants in group I used Evolve Pure™ Eyewipes twice a day to clean the eyelid debris along with standard therapy (antibiotic and lubricants) and participants in group II followed lid hygiene with warm compresses along with standard therapy. Symptoms, ocular surface assessment (lipid layer thickness, tear meniscus height, non-invasive tear film breakup time, and meibography), slit-lamp biomicroscopy (eyelash contamination, meibomian gland blockage, meibomian gland secretion, and meibomian gland telangiectasia) and tear film osmolarity were noted at baseline and 90 days after therapy. Results: Significant improvement in symptoms and signs of MGD was observed in both groups after treatment ( P < 0.001); however, the clinical improvement was better with the use of eyelid wipes. Lipid layer thickness increased significantly in group I ( P = 0.0006) and group II ( P = 0.0002), which was maintained even after adjusting for sociodemographic variables such as age, sex, and severity score of symptoms and signs. Conclusion: Lipid layer thickness of the tear film is a sensitive marker in monitoring response to treatment in patients with MGD. The use of physiological detergent-free eyelid wipes is non-inferior to lid hygiene and warm compresses, which remains the mainstay for treatment of MGD; the clinical improvement with eyelid wipes was noted to be better.

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Section: Discussionsupporting

confidence: 68%

“…Both the therapeutic arms in the current study facilitated an increase in the LLT of the patients with MGD, as has been reported by previously published studies. [ 17 18 19 ] On the contrary, other parameters such as TMH and NIBUT did not show an adequate trend of improvement. This result was in contrast to earlier studies.…”

Section: Discussionmentioning

confidence: 95%

Tear film lipid layer thickness measurement from Ocular Surface Analyzer as a marker to monitor treatment of meibomian gland dysfunction in a study comparing physiological detergent-free eyelid wipes with conventional therapy: A randomized trial

Gupta

Runda

Manna

et al. 2022

Indian Journal of Ophthalmology

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“…In the 4-week study, significant improvements were observed in the Ocular Surface Disease Index (OSDI) from baseline in both treatment groups at 2 and 4 weeks after treatment; besides, the 4-week change of −31.0 ± 18.4 in the iLux group was substantially greater than the 7-point threshold for clinical significance 20 . In previous studies, LipiFlow has shown a significant improvement in the OSDI and Standard Patient Evaluation of Eye Dryness (SPEED) scores in obstructive meibomian gland dysfunction patients 26,31 . In our study, at all the post-treatment visits, iLux was found to be noninferior to LipiFlow in least squares mean change from baseline in the IDEEL-SB module score.…”

Section: Discussionsupporting

confidence: 43%

“…20 In previous studies, LipiFlow has shown a significant improvement in the OSDI and Standard Patient Evaluation of Eye Dryness (SPEED) scores in obstructive meibomian gland dysfunction patients. 26,31 In our study, at all the post-treatment visits, iLux was found to be noninferior to LipiFlow in least squares mean change from baseline in the IDEEL-SB module score. In both the groups, a clinically meaningful reduction in IDEEL-SB scores was observed (>12-point reduction) at 12 months.…”

Section: Discussionmentioning

confidence: 50%

Comparison of Two Thermal Pulsation Systems in the Treatment of Meibomian Gland Dysfunction: A Randomized, Multicenter Study

Wesley

Bickle²,

Downing

et al. 2022

Optom Vis Sci

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SIGNIFICANCE: Given the significance of meibomian gland dysfunction subjects in evaporative dry eye, its chronic and progressive nature, limited promising treatment options, and novel treatment techniques are important. This randomized clinical study evaluated the noninferiority of SYSTANE iLux with LipiFlow in meibomian gland dysfunction treatment at 12 months. PURPOSE: This study aimed to demonstrate noninferiority of SYSTANE iLux compared with LipiFlow at 12 months after single treatment in meibomian gland dysfunction subjects with evaporative dry eye. METHODS: In this prospective, randomized, multicenter, assessor-masked, parallel-group trial, subjects (N = 236; aged ≥18 years) with meibomian gland score (MGS) of ≤12 in lower eyelids, noninvasive tear breakup time (NITBUT; first breakup) of <10 seconds, and Impact of Dry Eye on Everyday Life-Symptom Bother (IDEEL-SB) module score of >16 were randomized (1:1) to receive SYSTANE iLux (n = 119) or LipiFlow (n = 117). Subjects attended a total of eight visits, including screening, treatment, and follow-up visits at 2 weeks and at 1, 3, 6, 9, and 12 months/ exit, to evaluate change from baseline in MGS, NITBUT, IDEEL-SB module score, and safety outcomes.RESULTS: A total of 227 subjects completed the study (mean ± standard deviation age, 57.3 ± 13.8 years). At 12 months, least squares mean change from baseline in MGS was similar between iLux and LipiFlow (17.4 ± 1.97 vs. 17.8 ± 1.98). Noninferiority of SYSTANE iLux compared with LipiFlow in change from baseline in MGS (95% lower confidence limit of least squares mean difference, >−5), NITBUT (>−2.5 seconds), and IDEEL-SB score (95% upper confidence limit, <12) was achieved at all post-treatment visits. No other serious ocular or device-related adverse events were reported. CONCLUSIONS:The treatment outcomes with SYSTANE iLux were noninferior to LipiFlow during the 12-month follow-up in subjects with dry eye-associated meibomian gland dysfunction.

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“…For example, the LipiFlow Thermal Pulsation System (Johnson & Johnson Vision, Jacksonville, Florida) delivers a constant temperature of 42.58C during a 12-min treatment session while simultaneously pulsating in order to physically express meibum [40,41]. In one study, 200 individuals with MGD (OSDI!13, MG obstruction, lipid layer 80 mm) were either treated with LipiFlow (n ¼ 101, one treatment) or served as controls in a case-crossover design (n ¼ 99, treated with warm compresses 2Â/day for 3 months then LipiFlow) [42].…”

Section: Thermal and Massage Treatmentsmentioning

confidence: 99%

Alternative therapies for dry eye disease

Mittal

Patel

Galor

2021

Current Opinion in Ophthalmology

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Purpose of reviewDry eye disease (DED) is a multifactorial disease affecting approximately 5-50% of individuals in various populations. Contributors to DED include, but are not limited to, lacrimal gland hypofunction, meibomian gland dysfunction (MGD), ocular surface inflammation, and corneal nerve dysfunction. Current DED treatments target some facets of the disease, such as ocular surface inflammation, but not all individuals experience adequate symptom relief. As such, this review focuses on alternative and adjunct approaches that are being explored to target underlying contributors to DED. Recent findingsNeuromodulation, stem cell treatments, and oral royal jelly have all been studied in individuals with DED and lacrimal gland hypofunction, with promising results. In individuals with MGD, devices that provide eyelid warming or intense pulsed light therapy may reduce DED symptoms and signs, as may topical Manuka honey. For those with ocular surface inflammation, naturally derived anti-inflammatory agents may be helpful, with the compound trehalose being farthest along in the process of investigation. Nerve growth factor, blood-derived products, corneal neurotization, and to a lesser degree, fatty acids have been studied in individuals with DED and neurotrophic keratitis (i.e. corneal nerve hyposensitivity). Various adjuvant therapies have been investigated in individuals with DED with neuropathic pain (i.e. corneal nerve hypersensitivity) including nerve blocks, neurostimulation, botulinum toxin, and acupuncture, although study numbers and design are generally weaker than for the other DED sub-types. SummarySeveral alternatives and adjunct DED therapies are being investigated that target various aspects of disease. For many, more robust studies are required to assess their sustainability and applicability.

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Comparison of the therapeutic effect of Meibomian Thermal Pulsation LipiFlow® on obstructive and hyposecretory meibomian gland dysfunction patients

Cited by 15 publications

References 28 publications

Tear film lipid layer thickness measurement from Ocular Surface Analyzer as a marker to monitor treatment of meibomian gland dysfunction in a study comparing physiological detergent-free eyelid wipes with conventional therapy: A randomized trial

Tear film lipid layer thickness measurement from Ocular Surface Analyzer as a marker to monitor treatment of meibomian gland dysfunction in a study comparing physiological detergent-free eyelid wipes with conventional therapy: A randomized trial

Comparison of Two Thermal Pulsation Systems in the Treatment of Meibomian Gland Dysfunction: A Randomized, Multicenter Study

Alternative therapies for dry eye disease

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