BlephEx is another treatment for patients with MGD and consists of a medical-grade disposable micro-sponge that is applied to the edge of eyelids and lashes. The device removes debris and exfoliates eyelids. The treatments last about 6 to 8 minutes, and patients must maintain good eyelid hygiene and return for treatment every 4 to 6 months.
“In theory, it looks pretty good, but there is no data to show it’s beneficial,” Dr. Davidson said.
A fourth device is a thermoelectric heat pump (MiBo ThermoFlo, MiBo Medical Group) that liquefies the meibum and facilitates the expression of gland secretions. Heat is applied to the outside of the lids, breaking down hardened material inside the glands. The treatment takes up to 12 minutes each eye. One study showed improvement in 73% of patients who had had previous Lipiflow, Dr. Davidson said.
Yet another MGD treatment is intense pulsed light, for which there is a paucity of published data for ophthalmic indications, Dr. Davidson said.
However, some research has shown a reduction in artificial tear usage, a decrease in the Ocular Surface Disease Index score, and a reduction in lid margin edema and vascularity. Patients must return for maintenance treatments every 6 months to a year.
Finally, Dr. Davidson addressed intraductal meibomian gland probing, in which one study reported 96% of the 25 patients included had immediate post-probing relief.
However, the treatment can be painful, he added.
Dr. Davidson noted one drawback that may hurt in-office treatments for MGD is cost and reimbursement.