[RESULTS] Subjective symptoms ( mean Ocular Surface Disease Index , 42 19 to 33 21 ; P = 0.004 , mean Standard Patient Evaluation of Eye Dryness 16 7 to 12 7 ; P = 0.0001 ) , lipid layer thickness ( 44.0 15.6 to 51.3 20.4 ; P = 0.014 ) , number of expressible glands ( 2.9 1.6 to 6.4 4.6 ; P < 0.0001 ) , lid margin parallel conjunctival folds ( 2.3 1.0 to 2.0 0.9 ; P = 0.04 ) , and bulbar redness ( 1.4 0.5 to 1.2 0.5 ; P = 0.0001 ) were all improved 6 months after treatment .