Meibomian gland dysfunction: A comparative study of modern treatments

Purpose. - To evaluate a thermal pulsation treatment compared to a warming eyelid device for the management of meibomian gland dysfunction. Methods. - Thirty patients were randomized into two groups: the first had a treatment with MeioPatch on a daily basis for three months while the second had a single treatment with LipiFlow((R)). The evaluation focused on a classical approach but also on a modern approach of the ocular surface (interferometry lipid layer LipiView((R))), analysis fo the tear film by Oquas (osmolarity by TearLab((R))) before treatment, then a month and three months later. Results. - Both treatments proved to be effective with almost twice more in the MeiboPatch group (P < 0.05) but the LipiFlow allows a more raid improvemnt at the first month of treatment. Functional scores and classic exploration of the ocular surface except the Schirmer test also undergo a significant imrpovemnt in both groups after three months of treatment. Conclusion.- The combination of heat applied to the inner eyelid surafe, together with simultaneous expression of the glands, during a single 12-minute treatment shows to be highly effective in treating cases of meibomian gland disease. Whilst results were excellent, and continued lid hygiene remains advised, the benefit of being able to simultaneous address potential compliance issues relating to ongoing treatment is significant. The convenience of a single 12- minute treatment versus an ongoing daily heating regime was shown to be highly desirable and a welcome relief in our patients' busy lifestyles. (C) 2014 Elsevier Masson SAS. All rights reserved