Tear lipid layer thickness with eye drops in meibomian gland dysfunction

Abstract

PurposeThe aim of this study was to evaluate the efficacy of a lipid containing emollient eye drop, Soothe XP, which was reformulated in 2014 with a more stable preservative and buffer system, compared to a control, non-emollient, eye drop (Systane Ultra) in improving lipid layer thickness (LLT) in subjects with dry eye due to meibomian gland dysfunction (MGD).Patients and methodsThis prospective single-center, open-label, cross-over, examiner masked-study enrolled subjects aged 30–75 years with lipid-deficient dry eye and a clinical diagnosis of MGD as determined by a slit lamp examination, an evaluation of meibomian gland drop out with meibography, and a standard patient evaluation of eye dryness questionnaire of >5. Eligibility was then determined by a LLT of <75 nm at baseline and the inability to increase LLT ≥15 nm with three blinks, as determined by interferometric methods. Subjects were randomized to receive a single emollient or non-emollient eye drop at Visit 1 and were crossed over for the alternate treatment at Visit 2. At each visit, LLT was measured prior to and 15 minutes following the instillation of the assigned eye drop. The primary endpoint was the change in LLT from baseline.ResultsSubjects (n=40) were enrolled and 35 completed the two study arms. Mean (±SD) patient age was 55.7 years (10.9) and 69% were female. Mean (±SD) LLT at baseline was 49.5 nm (9.2). Instillation of Soothe XP resulted in an increase in LLT to 77.5 nm (29.3) 15 minutes following drop instillation, which is an increase of 28.0 nm (27.4) (P<0.001). In contrast, LLT 15 minutes after the instillation of Systane Ultra was 50.8 nm (14.1), which was not statistically significant when compared to the baseline LLT.ConclusionIn this study of subjects with MGD, the emollient, or lipid containing eye drop, increased the LLT of tears when measured 15 minutes after instilling a single eye drop.

Effect of a formulated eye drop with Leptospermum spp honey on tear film properties

“…Sample size calculation was powered for a specified change in LLT using a different device to that used in this study (Stroboscopic Video Colour Microscope (SVCM) vs LipiView II). Although both instruments use interferometric methods to measure LLT, the areas of the tear film evaluated differ between these two instruments: the SVCM images a circular area of 6 mm diameter, 15 whereas the LipiView images the inferior region of the tear film. 30 Therefore, this study may not have been appropriately powered to detect change in LLT.…”

<p>Changes in Tear Lipid Layer Thickness and Symptoms Following the Use of Artificial Tears with and Without Omega-3 Fatty Acids: ARandomized, Double-Masked, Crossover Study</p>

“…The inferior field is similar to that used in previous studies. 7,8 Assessment of the central and superior areas of the cornea is appropriate as the tear film moves on the ocular surface during a blink. 13 For this study, 900 frames were collected over 40 seconds for each measurement session.…”

“…Studies have found that eye drops containing emollients can help to increase the lipid layer thickness (LLT) of the tear film in the short term. 7,8 Omega-3 fatty acids can be found in the normal tear film, with profiles of these lipids correlating with dry eye severity. 9 While previous studies have found conflicting results as to whether dietary supplementation with omega-3 fatty acids can aid in the treatment of dry eye, 10,11 no studies to date have been done to determine if an eye drop containing omega-3 fatty acids can thicken the lipid layer of the tears.…”

Methods of Screening for Meibomian Gland Dysfunction

“…ISSN 1816-5095 (print); ISSN 2500-0845 (online) doi: 10.18008/1816-5095-2016-4-235-240 Методы скрининговой диагностики дисфункции мейбомиевых желез 1 Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Институт повышения квалификации Федерального медико-биологического агентства», ул. Гамалеи, 15, Москва, 123098, Российская Федерация Актуальность своевременной диагностики дисфункции мейбомиевых желез (ДМЖ) возрастает с каждым днем.…”

“…В первую очередь, это связано с тем, что в настоя-щее время изменились представления о распространен-ности данной патологии, которая по разным данным составляет от 40 до 71% населения в различных воз-растных группах [1,2,3]. Кроме того, данные научных исследований, направленных на изучение дисфункции мейбомиевых желез, свидетельствуют о том, что на их функциональное состояние оказывают влияние не толь-ко системные факторы, такие как дефицит андрогенов, менопауза, старение, синдром Шегрена, повышенное со-держание холестерина, псориаз, атопия, розовые угри, гипертония и доброкачественная гиперплазия простаты.…”