Efficacy and safety of a vectored thermal pulsation system (Lipiflow®) in the treatment of meibomian gland dysfunction: a systematic review and meta-analysis

Hu, Jindong; Zhu, Sixing; Liu, Xinquan

doi:10.1007/s00417-021-05363-1

Cited by 31 publications

(24 citation statements)

References 42 publications

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“…Meanwhile, we found that the LMT in normal subjects was less than that in MGD patients, suggesting that the measurement of LMT may be helpful for discriminating patients with early-stage MGD from normal subjects in the future. Finally, in theory, after the treatment of MGD with physical therapy [ 22 , 34 , 35 ], the LMT will become thinner correspondingly with the discharge of meibomian gland secretions. Concerning the changes of LMT after MGD treatment, it is worth further study.…”

Section: Discussionmentioning

confidence: 99%

Measurement of the Lid Margin Thickness in Meibomian Gland Dysfunction with Vernier Micrometer

et al. 2021

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Introduction To investigate the lid margin thickness (LMT) from the posterior lash line to the mucocutaneous junction at the middle position in adults with and without meibomian gland dysfunction (MGD) by vernier micrometer (VM). Methods This is a cross-sectional, observational study. A hundred eyes from 100 volunteers aged 20 to 79, including 56 normal participants and 44 participants with MGD, were recruited. Measurements of the LMT by VM were performed by the same person. Results The mean age of 56 normal subjects (24 males and 32 females) and 44 MGD subjects (16 males and 28 females) was 40.0 ± 13.2 years and 42.7 ± 17.1 years, respectively. There was a significant difference in the upper LMT between normal and MGD subjects (1.36 ± 0.25 vs. 1.60 ± 0.27 mm, P < 0.001), but not in the lower LMT (1.0 ± 0.23 vs. 1.10 ± 0.28 mm, P = 0.07). In both normal and MGD subjects, the upper or lower LMT was significantly positively correlated with age ( P < 0.05), and the upper LMT was greater than the lower LMT ( P < 0.001). In addition, the lower LMT in MGD subjects was significantly positively correlated with meibum expressibility ( r s = 0.35, P = 0.02). Conclusions The LMT was closely related to age and could be an important indicator for detecting MGD. Furthermore, we found that the upper LMT was greater than the lower LMT, and the lower LMT in MGD subjects seemed to be related to meibum expressibility.

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Section: Discussionmentioning

confidence: 99%

Measurement of the Lid Margin Thickness in Meibomian Gland Dysfunction with Vernier Micrometer

et al. 2021

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“…MiBo Thermoflo was compared with LipiFlow in a preliminary, randomized, assessor-masked study (n = 54 patients [108 eyes]), which found significant improvements in signs and symptoms for both treatments at 1and 2-month follow-up, with no significant differences between groups [112]. Across studies, in-office thermal treatments appeared to be well tolerated, with no device-related serious adverse events reported [105,[109][110][111][112]. As these treatments can be relatively expensive for some patients and are not covered by insurance, cost may be a barrier to access.…”

Section: Thermal Pulsationmentioning

confidence: 99%

Dry Eye Disease Associated with Meibomian Gland Dysfunction: Focus on Tear Film Characteristics and the Therapeutic Landscape

Sheppard

Nichols

2023

Ophthalmol Ther

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Meibomian gland dysfunction (MGD) is highly prevalent and is the leading cause of evaporative dry eye disease (DED). MGD is characterized by a reduction in meibum secretion and/or a change in meibum composition that results in the disruption of the tear film lipid layer and an increase in the tear film evaporation rate. Excessive evaporation causes tear film instability, desiccation, tear hyperosmolarity, inflammation, and apoptosis of ocular surface cells, resulting in a continuous cycle of DED. The primary treatment goal for DED associated with MGD is to restore the tear film lipid layer and decrease evaporation, thereby reducing ocular signs and symptoms. The management of MGD includes home care options (eyelid hygiene, warming eye masks, ocular lubricants) and office-based treatments (manual expression, microblepharoexfoliation, thermal pulsation, intense pulsed light, intraductal probing).Topical ophthalmic prescription medications attempt to alter various factors that may contribute to DED (e.g., inflammation, bacterial growth, inadequate tear production). In this review, clinical evidence regarding available treatments and emerging therapies from randomized studies in patients with DED associated with MGD is summarized. Although some treatment modalities have been evaluated specifically for DED patients with MGD, largescale randomized controlled trials are needed to confirm efficacy and safety in this patient population. Currently, there are no approved prescription pharmacologic treatments specifically indicated for DED associated with MGD, and those medications approved for the treatment of DED do not target the key driver of the disease (i.e., excessive evaporation). NOV03 (perfluorohexyloctane; under review with the US Food and Drug Administration) is the most advanced emerging therapy for DED associated with MGD and has demonstrated statistically significant improvements in both signs and symptoms in randomized controlled trials. Development of novel pharmacotherapies will improve therapeutic options and allow for a more individualized approach for patients with DED associated with MGD.

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“…11 For patients with MGD, additional treatment options include warm compresses with lid massage, manual meibomian gland expression, oral omega supplements, thermal pulsation, intraductal probing, intense pulsed light, and topical antibiotics, which are aimed at improving meibomian gland expressibility. 22,[86][87][88][89][90][91][92] For patients with aqueous deficiency, additional possible therapies include moisture chamber eye wear and punctal plugs, which are aimed at improving retention of the aqueous tear film. 93,94 Importantly, eyelid disease and inflammation may need to be treated before the insertion of punctal plugs so that infection and inflammatory mediators may first be cleared.…”

Section: Dovepressmentioning

confidence: 99%

Personalized Management of Dry Eye Disease: Beyond Artificial Tears

Matossian¹,

Crowley²,

Periman³

et al. 2022

OPTH

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Dry eye disease (DED) is a multifactorial disease of the ocular surface that may be accompanied by discomfort and visual disturbances to a level that reduces quality of life. Artificial tears are a common first-line therapy for DED that aim to supplement the tear film but do not address the underlying causes of DED. Because of the complexity and variability of the disease, personalized treatment beyond artificial tears is important for successful management. This review describes artificial tears and the current knowledge in the personalized approach to the management of DED. There is evidence that artificial tears can reduce symptoms and signs of DED; however, a proportion of patients have been found to show limited or no improvement with artificial tears. Furthermore, the effectiveness of artificial tears may depend on patient compliance and type of artificial tear product used. Personalized management of DED with other treatments involves identifying features of the disease, including the subtype of DED, the presence of inflammation, and the coexistence of external and behavioral contributing factors. Various measures exist to characterize DED, including assessments of the tear film lipid layer, the meibomian glands, tear volume, tear osmolarity, and matrix metalloproteinase 9 levels. Because individuals can show variable features, the most prominent clinical findings, comorbidities, triggering events, and treatment history should be considered to determine the best treatment choices for patients.

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Efficacy and safety of a vectored thermal pulsation system (Lipiflow®) in the treatment of meibomian gland dysfunction: a systematic review and meta-analysis

Cited by 31 publications

References 42 publications

Measurement of the Lid Margin Thickness in Meibomian Gland Dysfunction with Vernier Micrometer

Measurement of the Lid Margin Thickness in Meibomian Gland Dysfunction with Vernier Micrometer

Dry Eye Disease Associated with Meibomian Gland Dysfunction: Focus on Tear Film Characteristics and the Therapeutic Landscape

Personalized Management of Dry Eye Disease: Beyond Artificial Tears

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