The Clinical Study Of Meibomian Thermal Pulsation LipiFlow? For Treating Meibomian Gland Dysfunction

SUBJECT To evaluate the safety and clinical value of Meibomian Thermal Pulsation LipiFlow ? for treating meibomian gland dysfunction(MGD).Methods Prospectively randomized case series analysis study.25 subjects(50 eyes)diagnosed MGD with dry eye who match the criteria were collected in the ophthalmic outpatient clinic from May to September 2016.All subjects undegwent the therapy of the Meibomian Thermal Pulsation LipiFlow? and all the test results were recorded before?4 weeks?8 weeks?12 weeks after the treatment including Standard Patient Evaluation of Eye Dryness(SPEED)?Ocular Surface Disease Index(OSDI)? Best Corrected Visual Acuity(BCVA)? Intraocular Pressure(IOP)?Schirmer I test(SIT).Lipid Layer Thickness(LLT)?Partial Blink(PB)?meibomian gland morphology and Meibomian Gland Dropout Rate(MGDR)were assessed by an ocular surface interferometer LipiView?.The lid margin?meibomian gland orificies?palpebral conjunctiva?bulbar conjunctiva?cornea.Tear break up time(BUT)?Cornea Fluorescein Staining(FL)were evaluated under a slit-lamp biomicroscope.Meibomian Glands Yielding Liquid Secretion(MGYLS)?Meibomian Glands Yielding Secretion Scores(MGYSS)were evaluated by the Meibomian Gland Evaluator(MGE)respectively.Line of Marx(LOM)was evaluated after the issamine green.Record all the results respectively.RESULTS Symptoms of all subjects alleviated as time goes by.8/22 eyes' limbal hyperaemia disappeared after 4weeks treatment compared to the baseline.All 50 eyes had different degrees of pachyblepharon,meibomian gland orifice occlusion and the situation gradually improved after 12 weeks of treatment but didn't fully restored to normal structure.14 eyes of conjunctival congestion?8 eyes of conjunctival hyperemia and 26 eyes of corneal epithelial roughness totally disappeared after 4 weeks treatment.SPEED?OSDI declined gradually with statistically significant difference(P<0.001).BCVA?FL?SIT significantly improved after 4weeks(P<0.001)and could maintain in 8 and 12 weeks.There was no statistically significant difference between the pretreatment and postreatment in IOP?meibomian gland morphology?line of MARX after 12 weeks(P>0.05).Similarly there were statistically significant differences in BUT?LLT from baseline to 4 weeks posttreatment,but declined gradually in 8weeks and 12weeks(P<0.001).MGYLS and MGYSS improved in 4weeks and 8weeks,but get declined in 12weeks(P<0.001),and the opposite went with PB,there was statistically significant decline in PB in 4weeks and 8weeks compared to the baseline,but get incresed in 12weeks(P<0.001).Spearman Correlation Analysis show the significant correlations between MGYLS and LLT?MGYLS and MGYSS before and 4weeks?8weeks?12weeks after treatment(P<0.001).There were significant correlations between BUT and MGYLS?BUT and MGYSS after 4weeks time(P<0.001).And there was correlation between MGYLS and SIT pretreat.No side effect was obseverd during the whole treatment.CONCLUSION The Meibomian Thermal Pulsation LipiFlow ? offers a significantly technologically advance for treating MGD with dry eye.With improvement in the ocular symptoms?BUT?quantity and quality of the meibomian glands.There are no pain,no side effects during the treatment.It results in sustained improvement of MGD up to 3 months.The unparalleled treatment for MGD is worth spreading.