Inclusion Criteria:  tear break-up time (BUT) ≤10 seconds or Schirmer I test (SIT) ≤10 mm, the presence of dry eye symptoms, and fluorescein staining (FL) score <3 points and at least one lid margin abnormality and poor meibomian gland expressibility  Exclusion Criteria:  eyelid structure abnormal(Entropion , ectropion); having received any other treatment for MGD within three months history of ocular surgery contact lens use ocular infection any type of corneal scarring