No quantitative synthesis was attempted for either mebiomian plugging or meibomian secretion scores and no significant changes were observed with any other outcome parameter .
Conclusion : Only the systemic antimicrobials were found to improve the clinical features of meibomian gl and dysfunction .
Varying effects of different therapeutic agents ( heat therapies , omega-3-fatty acids and castor oil ) were identified for MGD but the risk of bias pertaining to r and omization and allocation concealment was found to be associated with most of the current RCTs .
Introduction : Meibomian Gl and Dysfunction ( MGD ) is a common , often overlooked , chronic condition affecting eyes for which various therapies are being evaluated .
Considering the absence of a systematic review and meta- analysis , the present review was carried out .
A Randomized, Controlled Treatment Trial of Eyelid-Warming Therapies in Meibomian Gland Dysfunction
Abstract Aim The main treatment for meibomian gl and dysfunction ( MGD ) , a major cause of dry eye , is eyelid warming . Lack of compliance is the main reason for treatment failure . This has led to the development of eyelid-warming devices that are safe , effective and convenient . To obtain robust evidence demonstrating their efficacy , the authors conducted a 3-arm r and omized clinical study . Methods The authors conducted a 3-month assessor-blinded , r and omized , controlled trial of patients from the Singapore National Eye Centre experiencing at least one of eight dry eye symptoms ‘ often ’ or ‘ all the time ’ . Patients who wore contact lenses , had an active infection or known diagnosis of thyroid dysfunction and rheumatoid arthritis were excluded from the study . MGD participants were r and omly assigned to warm towel ( n = 25 ) , EyeGiene ® ( Eyedetec Medical Inc. , Danville , CA , USA ) ( n = 25 ) and Blephasteam ® ( Spectrum Thea Pharmaceuticals LTD , Macclesfield , UK ) ( n = 25 ) treatments . The primary efficacy and safety outcomes included the proportions of participants with improved symptoms and changes in best corrected visual acuity ( BCVA ) , respectively . Other outcomes included tear break up time ( TBUT ) , Schirmer test , corneal fluorescein dye staining and number of visibly occluded meibomian gl and ( MG ) orifices . Results The study population was 53.5 ± 11.1 years old and predominantly Chinese . For severity of symptom after 3 months of treatment , 78.3 % Blephasteam ® participants reported improvement compared to 45.5 % warm towel participants ( p = 0.023 ) . The corresponding proportions for improvement in the frequency of symptoms were 82.6 % and 50.0 % , respectively ( p = 0.020 ) . The proportions of improvement of symptoms in EyeGiene ® patients were not significantly different from warm towel intervention . At 1 month of treatment , the crude odds ratio of improvement of severity of irritation for Blephasteam ® compared to control was 3.0 ( 95 % CI 0.88–10.18 ) . However , the odds ratio adjusted by age was 5.67 ( 1.30–24.66 ) . The lid-warming treatments did not significantly change the TBUT , Schirmer test results or number of visibly occluded MGs in the study period . All treatment modalities did not worsen BCVA after 3 months . Conclusion Blephasteam ® is more effective than warm towel for MGD treatment , with warm towel and EyeGiene ® being comparable effective . Older age might predict for treatment efficacy . All studied therapies were safe for visual acuity ( VA ) for 3 months of treatment
No quantitative synthesis was attempted for either mebiomian plugging or meibomian secretion scores and no significant changes were observed with any other outcome parameter .
Conclusion : Only the systemic antimicrobials were found to improve the clinical features of meibomian gl and dysfunction .
Varying effects of different therapeutic agents ( heat therapies , omega-3-fatty acids and castor oil ) were identified for MGD but the risk of bias pertaining to r and omization and allocation concealment was found to be associated with most of the current RCTs .
Introduction : Meibomian Gl and Dysfunction ( MGD ) is a common , often overlooked , chronic condition affecting eyes for which various therapies are being evaluated .
Considering the absence of a systematic review and meta- analysis , the present review was carried out .