Repeatability of biometry in patients with meibomian gland dysfunction before and after vectored thermal pulsation therapy: A randomized, controlled trial

Abstract

PurposeTo evaluate the effect of vectored thermal pulsation therapy (VTPT) on the repeatability of biometry readings of two different optical biometers in patients with meibomian gland dysfunction (MGD).MethodsPatients affected by MGD were included in this prospective, randomized, controlled, investigator‐masked study. One eye was randomized to VTPT (LipiFlow®, Johnson & Johnson), and the contralateral eye served as a control. Three visits were scheduled at baseline, 2 weeks and 3 months after the treatment. The main outcome parameter of the study was the repeatability of three calculations of emmetropic intraocular lens power (EIOLP) at the 3 months visit as compared to baseline using an optical biometer (IOLMaster® 700, Carl Zeiss Meditec AG). Repeatability of different keratometry values obtained by the optical biometer and a Placido‐disc topographer (MS‐39®, CSO) served as secondary outcome parameters.ResultsTwenty‐nine patients were included in the final analysis. While tear film parameters improved in the study eyes, there were no significant differences regarding the repeatability of three EIOLP measurements between baseline and 3‐months‐visit in both eyes (p > 0.05) and keratometry measurements in both the optical biometer and the Placido‐disc topographer. Remarkably, throughout all study visits, there were some outliers regarding the repeatability of measurements.ConclusionWhile both devices showed high repeatability regarding EIOLP and keratometry, future studies are needed to detect high‐risk patients for poor repeatability.

Vectored Thermal Pulsation as a Treatment for Meibomian Gland Dysfunction: A Review Spanning 15 Years

“…Three studies evaluated the effect of pre-operative LipiFlow treatment on intraocular lens (IOL) selection. One study of 31 patients (29 eyes) with MGD concluded that LipiFlow improved tear film parameters but had negligible effect on spherical IOL selection [ 63 ]. In contrast, two studies of 29 patients with MGD (36 eyes) concluded that LipiFlow treatment stabilized the tear film and improved the accuracy of the IOL power calculations especially the keratometry readings [ 64 , 65 ].…”

“…Four studies evaluated the safety of LipiFlow when treating MGD in patients with cataract (235 patients, 229 eyes), and the data are presented in Table 6 . There were no AEs, pain, or safety concerns related to LipiFlow treatment [ 63 , 66 , 67 , 69 ].…”

“…Cataract surgery can cause or worsen MGD and is associated with loss of MG and deterioration of gland morphology [60][61][62]. In addition, DED in general can cause imprecision of biometry and keratometry readings resulting in suboptimal refractive results [63]. Accordingly, seven studies evaluated the effect of LipiFlow on 280 patients (271 eyes) undergoing cataract surgery, and the studies are described in Table 6.…”