Study: Effect of dry eye products, warm compress for MGD therapy

Take-Home

A line of products used for the temporary relief of burning and irritation caused by dry eye was shown to increased meibomian gland function from baseline compared with warm compresses.

By Lynda Charters; Reviewed by Victor Finnemore, OD, FAAO

Boston-Symptoms of lipid-deficient evaporative dry eye disease can be alleviated with therapeutics that increase the number of meibomian glands yielding liquid secretion.

A line of products (Systane Family of Products, Alcon Laboratories) used for the temporary relief of burning and irritation caused by dry eye increased meibomian gland function from baseline compared with warm compresses with or without saline-the standard of care.

“Meibomian gland dysfunction (MGD) is one of the leading causes of dry eye disease, which is characterized by decreased liquid secretion or a decreased number of meibomian glands yielding liquid secretion and altered gland anatomy,” said Victor Finnemore, OD, partner and clinical researcher at Korb and Associates, Boston.

Dr. Korb and colleagues conducted a 3-month, single-center, open-label, investigator-masked, prospective evaluation of patients diagnosed with lipid-deficient evaporative dry eye and six or fewer functioning meibomian glands during screening. Patients completed screening at baseline and examinations at 1, 2, and 3 months of treatment.

The 3-month study included random assignment to either the Systane products (Lid Wipes once daily, Systane Balance eye drops four times daily, and two oral vitamins once daily) or the application of warm wet compresses to both eyelids for 8 minutes once daily, according to Dr. Finnemore.

The primary endpoint was the functionality of the meibomian glands. The Korb Meibomian Bland Expressor was used to assess the meibomian gland function. The investigators determined the number of meibomian glands yielding liquid secretion at the four time points. Best-corrected visual acuity (BCVA) and adverse events were recorded.

A look at the results

Twenty-six patients (21 women, 5 men; 52 eyes) were included in the study, 13 in each of the two study groups. The mean patient age was 41.7 years (range, 18 to 72 years).

“The meibomian gland functionality was significantly better in the Systane group compared with the warm compresses groups at months 2 and 3,” Dr. Finnemore said.

At the baseline evaluation the mean numbers of meibomian glands yielding liquid secretion were similar in the two groups, i.e., 3.5 ± 1.50 in the Systane group and 4.2 ± 1.39 in the warm compresses group. In the Systane group, the mean numbers increased compared with baseline at all time points: 7.0, 6.4, and 9.3 at months 1, 2, and 3 compared with 3.9, 3.5, and 4.7 in the warm compresses group at the same time points. The differences were significant at months 2 and 3 (p = 0.365 and p = 0.0061, respectively).

The safety profile of the products was good and no serious adverse events were reported. One patient reported infectious mononucleosis and sinusitis that were not related to treatment. BCVA did not change during the study.

Dr. Finnemore also commented on the condition of the eyelids.

“The lid status improved markedly compared with baseline in the Systane group,” he said. “At month 3, 80.8% of eyes in the Systane group had no desquamated debris and collarettes, compared with 38.5% of eyes in the standard care group. The investigators observed desquamated debris on the epidermis in two eyes and eyelashes in six eyes and collarettes in 14 eyes in the standard care group.”

Treatment with the dry eye products was particularly effective in alleviating desquamated debris and collarettes, he noted.

Investigators concluded that the number of meibomian glands yielding liquid secretion increased with use of the dry eye products. Meibomian gland functionality was significantly better after 2 and 3 months of treatment with the products compared with the standard of care.

Donald R. Korb, OD

E: drkorb@aol.com

This article was adapted from Dr. Finnemore’s presentation at the 2014 meeting of the Association for Research in Vision and Ophthalmology. Dr. Finnemore was joined in this study by Teresa Douglass, AB, COT, Abayomi Ogundele, PharmD, and Donald R. Korb, OD. No author had a financial interest in any aspect of this report. Alcon Research Ltd. sponsored the study.