Efficacy of Intraductal Meibomian Gland Probing on Tear Function in Patients With Obstructive Meibomian Gland Dysfunction

Ma, Xiaoli; Lu, Yan

doi:10.1097/ico.0000000000000777

Cited by 39 publications

(64 citation statements)

References 26 publications

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“…Although the safety and effectiveness of IPL and MGP have been proved by previous studies 8,9,[11][12][13] , the deficiency of IPL and MGP could also be observed in our day-to-day clinical observation. The effect of IPL to open stubborn intraductal congestion or intraductal scar is comparatively limited.…”

Section: Introductionsupporting

confidence: 47%

“…Meibomian gland probing opened the obstructed orifices and ducts mechanically. With the pop up of constrained meibum, keratinized epithelium and debris, vicious cycle of o-MGD progression was broken and the majority of patients received immediate relief of symptoms 11,16 . However, the quantity of meibum in ocular surface is not a decisive factor in retarding the evaporation of aqueous and stabilizing the tear film.…”

Section: Discussionmentioning

confidence: 99%

“…We assumed that the single mechanical function of MGP to improve the meibum lipid quality is limited. Xiao Ma et al recommended the use of 0.1% fluorometholone after MGP to diminish inflammation, as MGP predispose the lid margin to a topical corticosteroid effect 11 . But we think, although MGP increased the accessibility of gland to antiinflammatory drugs, traditional application of eyedrops or eye ointment after MGP can hardly deliver drugs to the deepest gland lumens.…”

Section: Discussionmentioning

confidence: 99%

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Clinic Results of Intraductal Meibomian Gland Probing Combined Intense Pulsed Light in Treating Patients With Refractory Obstructive Meibomian Gland Dysfunction: A Randomized Controlled Trial

Huang

Qin²,

Wang

et al. 2019

Preprint

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Background: To optimize therapeutic regimen for refractory obstructive meibomian gland dysfunction (o-MGD) patients by combining intraductal meibomian gland probing (MGP) and intense pulsed light (IPL) to enhance their effect and reduce their limitations. Methods: This randomized, assessor blind study include 45 patients (90 eyes) with refractory o-MGD. They were divided into 3 groups by allocation concealment: IPL (group I, received an IPL treatment course: 3 times at 3-week intervals), MGP (group II, received MGP one time) and MGP combined IPL (group III, MGP at first then an IPL treatment course). Standard Patient Evaluation of Eye Dryness score (SPEED), tear break-up time (TBUT), corneal fluorescein staining (CFS), meibum grade and lid margin finding results were assessed at baseline, 3 weeks after final treatment in group I and III, 3 and 12 weeks after MGP in group II. Six months after final treatment, the SPEED and willingness to receive any treatment again were also collected in all groups. Paired Wilcoxon, Mann-Whitney U with Bonferroni correction and Kruskal-Wallis tests were used for data analysis. Results: In 3 groups, all above indexes improved significantly after treatment (all P＜0.01). MGP-IPL was better than IPL and MPG in posttreatment SPEED, TBUT, meibum grade, lid telangiectasia (all P＜0.05/3). Besides, the MGP-IPL was better than IPL in lid tenderness and better than MGP in orifices abnormality (all P＜0.05/3 ). Six months later, the SPEED in MGP-IPL was also significantly lower than other groups (all P＜0.05/3). And no patients in MGP-IPL group revealed the need to be treated again, while 35.7% or 20% of patients with IPL or MGP need retreatment. Conclusions: Compared with single IPL or MGP, the combination of MGP and IPL demonstrated the most efficient results in relieving all signs and symptoms and can help patients attain the most lasting symptom relief. Trial registration: http://clinicaltrials.gov, ChiCTR1900021273 (retrospectively registered 09 February 2019). Funding: This work was supported by the National Natural Science Foundation of China: [grant numbers: 81870624; 81700802]; Major Science and Technology Projects of Zhejiang Province [grant numbers: 2017C03046].

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Section: Introductionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinic Results of Intraductal Meibomian Gland Probing Combined Intense Pulsed Light in Treating Patients With Refractory Obstructive Meibomian Gland Dysfunction: A Randomized Controlled Trial

Huang

Qin²,

Wang

et al. 2019

Preprint

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“…56 A randomised, controlled study of 25 patients with obstructive MGD showed that both signs and symptoms were improved one month after probing. 57 Other studies have demonstrated the safety and efficacy of probing for patients with obstructive MGD. [58][59][60] Moreover, probing was associated with an increase in meibomian gland area 61 as determined by non-invasive meibography.…”

Section: Intraductal Probingmentioning

confidence: 99%

Non‐pharmaceutical treatment options for meibomian gland dysfunction

Arita

Fukuoka

2020

Clinical and Experimental Optometry

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This review examines currently available non-pharmaceutical treatment modalities for meibomian gland dysfunction. A detailed search of the PubMed and MEDLINE databases was performed to identify original articles in English that have evaluated such nonpharmaceutical therapies in patients with this condition. Conventional therapies such as application of a warming compress, the practice of lid hygiene, and manual expression of meibomian glands as well as more technologically advanced approaches such as intraductal probing, thermal pulsation, and intense pulsed light therapy are included in the review. These non-pharmaceutical treatment options may each have a role to play in the management of meibomian gland dysfunction, but more studies are necessary to compare treatments directly under identical experimental conditions in order to determine their relative efficacy. Additional large-scale, randomised, controlled trials are also required to provide more information such as the specific indications best suited to each treatment modality, the efficacy of such approaches in combination with pharmaceutical-based therapy, and the mechanisms of action of some of the more technologically advanced systems.

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“…Intraductal probing is a highly invasive procedure, which has been reported to offer functional improvement in the most severe cases of obstructive MGD that are unresponsive to other forms of treatment . Further research is required to confirm the absence of structural or fibrotic damage, to the fragile gland structures, in the longer term.…”

Section: Optimising Tear Film and Ocular Surface Health For Contact Lmentioning

confidence: 99%

Tear film evaluation and management in soft contact lens wear: a systematic approach

Downie

Craig

2017

Clinical and Experimental Optometry

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The human tear film is a highly ordered structure consisting of a thin layer of lipid on the surface and a thicker aqueous-mucin phase, which increases in mucin concentration toward the corneal epithelial cell layer. The health of the tear film and ocular surface influences the likelihood of being able to achieve successful contact lens wear. Contact lens discomfort and dryness are the most frequent reasons why contact lens wearers experience reduced wearing times, which can eventually lead to contact lens discontinuation. Comprehensive clinical assessment of tear film integrity and ocular surface health is therefore essential prior to commencing contact lens wear, to enable the ocular surface environment to be optimised to support lens wear. These parameters should also be evaluated over the course of contact lens wear, in order to identify any aspects requiring clinical management and ensure maintenance of optimal lens-wearing conditions. This review summarises current knowledge relating to the effects of soft contact lens wear on the tear film and ocular surface. It also provides a systematic approach to evaluating tear film and ocular surface integrity, in order to guide the clinical management of tear film anomalies with respect to contact lens wear.Key words: conjunctiva, contact lenses, cornea, dry eye, tearsThe tear film is a complex, precisely ordered fluid structure comprising a thin outer layer of lipid and a thicker underlying aqueous-mucin phase, with increasing mucin concentration toward the corneal epithelial cell layer. A thin layer of membrane-bound mucin, glycocalyx, imparts hydrophilicity to the hydrophobic corneal surface.1 In excess of 1,000 proteins or fractions of proteins have been identified within the human tear film.2,3 The tear fluid also contains a variety of regulated inflammatory mediators, including by-products of arachidonic acid metabolism, the complement cascade, cytokines and components derived from the ocular microbiome. 3,4The integrity of the tear film can strongly influence the likelihood of achieving successful contact lens wear. Contact lens discomfort and dryness are the most frequent reasons why contact lens wearers experience reduced wearing times, which can eventually lead to contact lens discontinuation. 5 Comprehensive clinical assessment of tear film quality and quantity, and ocular surface health are therefore essential both prior to commencing contact lens wear, to enable the ocular surface environment to be optimised to support lens wear, and over the course of lens wear, to identify any aspects requiring clinical attention to maintain optimal lens-wearing conditions. This review summarises current knowledge relating to the effects of soft contact lens wear on tear film composition, and outlines an approach to evaluating tear film and ocular surface integrity, to guide the clinical management of tear film anomalies with respect to contact lens wear. ASSESSING THE TEAR FILM AND OCULAR SURFACE IN CONTACT LENS WEAR: A SYSTEMATIC APPROACHUsing techniques such as in...

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Efficacy of Intraductal Meibomian Gland Probing on Tear Function in Patients With Obstructive Meibomian Gland Dysfunction

Abstract: Intraductal meibomian gland probing demonstrated significant efficacy in symptom relief and tear film stabilization. Probing helped release accumulated meibum and could help increase the accessibility of diseased meibomian glands to topical corticosteroids.

Cited by 39 publications

References 26 publications

Clinic Results of Intraductal Meibomian Gland Probing Combined Intense Pulsed Light in Treating Patients With Refractory Obstructive Meibomian Gland Dysfunction: A Randomized Controlled Trial

Clinic Results of Intraductal Meibomian Gland Probing Combined Intense Pulsed Light in Treating Patients With Refractory Obstructive Meibomian Gland Dysfunction: A Randomized Controlled Trial

Non‐pharmaceutical treatment options for meibomian gland dysfunction

Tear film evaluation and management in soft contact lens wear: a systematic approach

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