Alice Epitropoulos, MD, and Arjan Hura, MD, conducted a retrospective, observational study to determine whether there were changes in the visible gland structure (VGS) of the lower lids of patients who had undergone thermal pulsation therapy.
Most patients with dry eye disease have meibomian gland dysfunction (MGD) as a primary or contributory cause of their ocular surface problems.1 We know that MGD is a progressive disease that gets worse the longer it goes untreated. Over time, the glands become obstructed, which then leads to meibomian gland atrophy.
Established treatments for MGD include re-esterified omega-3 fatty acid supplementation, lid hygiene measures (lid scrubs and warm compresses), blepharoexfoliation, and thermal pulsation therapy. Thermal pulsation therapy has been widely viewed as most effective when performed earlier in the disease process, before a patient reaches end-stage MGD with significant gland atrophy and dropout.
Although it was previously unknown whether thermal pulsation therapy could reverse gland atrophy, the general consensus is that atrophy is permanent. In order to evaluate this presumption more closely, we conducted a retrospective, observational study to determine whether there were changes in the visible gland structure (VGS) of the lower lids of patients who had undergone thermal pulsation therapy.2
Alice Epitropoulos, MD
E: [email protected]
Dr. Epitropoulos is in private practice at Ophthalmic Surgeons and Consultants of Ohio and is a clinical assistant professor at The Ohio State University. She is a consultant for Allergan, BlephEx, Johnson & Johnson Vision, PRN Nutriceuticals, Shire, and TearLab.
Arjan Hura, MD
E: [email protected]
Dr. Hura is an ophthalmology resident at the University of Cincinnati. Investigator initiated financial support for this study was provided by Johnson & Johnson Vision.
1. Lemp MA, Crews LA, Bron AJ, et al. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort. Cornea. 2012;31: 472-478.
2. Hura A, Epitropoulos A, Czyz C, et al. The potential effect of LipiFlow on meibomian gland structure: A repliminary analysis utilizing dynamic meibomian imaging. ARVO Poster 935 –B0113, 2018.
3. Greiner JV. Long-term (3-year) effects of a single thermal pulsation system treatment on meibomian gland function and dry eye symptoms. Eye Contact Lens. 2016;42:99-107.
4. Blackie CA, Coleman CA, Holland EJ. The sustained effect (12 months) of a single-dose vectored thermal pulsation procedure for meibomian gland dysfunction and evaporative dry eye. Clin Ophthalmol. 2016;10:1385-1396.
5. Gupta PK, Stevens MN, Kashyap N, Priestley Y. Prevalence of meibomian gland atrophy in a pediatric population. Cornea. 2018;37:426-430.
6. Epitropoulos AT, Donnenfeld ED, Shah ZA, et al. Effect of oral re-esterified omega-3 nutritional supplementation on dry eyes. Cornea. 2016;35:1185-1191.
7. Epitropoulos AT, Matossian C, Berdy GJ, et al. Effect of tear osmolarity on repeatability of keratometry for cataract surgery planning. J Cataract Refract Surg. 2015;41:1672-1677.