Comparison of therapeutic effects between a new warm moist air device assisted with eyelid massage and eyedrops with only eyedrops for meibomian gland dysfunction

Background

Meibomian gland dysfunction (MGD) is a common eye disease that leads to ocular surface damage.Conventional treating method is hot compress with heating pads or warm towels combined with eyelid massage, but the temprature of heat source is difficult to ensure precisely.A new warm moist air device is used in ophthalmology now, however, its clinical effect for MGD is under evaluation.

Objective

This study was to evaluate the therapeutic effects of a new warm moist air device assisted with eyelid massage for MGD.

Methods

A randomized-controlled clinical trail was performed.Sixty MGD patients were recruited in Tonghua Eye Hospital from January to June 2015.The patients were divided into two groups according to random number table with matched age, gender and the findings of ocular surface, and the unilateral eyes of the patients were used to analysis.The eyes in the trail group received topical administration of polyethylene glycol eye drops and new warm moist air device combined with eyelid massage, and the eyes in the control group received only topical administration of polyethylene glycol eye drops.The eye examinations were carried out before treatment and 2, 4 weeks after treatment, including ocular surface disease index questionnaire (OSDI), meibomian gland function under the slit lamp microscope, breakup time of tear film (BUT), corneal fluorescein staining scores and Schirmer Ⅰtest (SⅠt). The treating results over time were intergrouply compared.This study protocol was approved by Ethic Committee of Tonghua Eye Hospital, and written informed consent was obtained from each patient prior to entering the group.

Results

All the patients finished this therapeutic process.In the trail group, the OSDI scores were 13.29±4.06 and 9.29±3.21 at 2 and 4 weeks after treatment, which were significantly lower than those in the control group (16.82±3.21 and 15.41±4.03) (t=-3.5, -6.12, both at P<0.01). The BUT values were (6.98±1.34) seconds and (7.84±1.32) seconds at 2 and 4 weeks after treatment in the trail group, and those in the control group were (5.42±1.03) seconds and (5.41±1.45) seconds, showing significant differences between the two groups (t=5.16, 8.04, both at P<0.01). The scores of meibum quality were 7.91±2.24 and 6.72±1.54 at 2 and 4 weeks after treatment in the trail group, which were significantly lower than those in the control group (10.34±2.35 and 10.23±2.86) (t=4.14, 6.00, both at P<0.01). The corneal fluorescein staining scores were insignificantly increased in the trail group compared with the control group (F_group=0.03, P>0.05). In addition, there were not significant differences in SⅠt and meibomian gland secretory levels over time between two groups (SⅠt: F_group=0.10, P>0.05; F_time=0.72, P>0.05; secretion: F_group=1.64, P>0.05; F_time=0.92, P>0.05).

Conclusions

This new warm moist air device assisted with eyelid massage and polyethylene glycol eye drops can effectively treat MGD, and this combination therapy appears to have a favorable therapeutic effects in comaprison with only polyethylene glycol eye drops.

Meibomian gland dysfunction/therapy; Ocular surface diseases/therapy; Tear film; Prospective study; Randomized-controlled clinical study; Water vapor heating apparatus, ophthalmology/therapeutic use