Effects of controlled heat delivery to the eyelid margin & eyelid

3/29/2015
Effects of controlled heat delivery to the eyelid margin & eyelid hygiene on symptomatology and the tear film in MGD ­­ Guillon et al. 54 (6): 6044 ­­ ARV…
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Invest Ophthalmol Vis Sci 2013;54: E­Abstract 6044.
© 2013 ARVO Year: [advanced]
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6044—A0107
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Effects of controlled heat delivery to the
eyelid margin & eyelid hygiene on
symptomatology and the tear film in
MGD
Michel Guillon1,2, Cecile Maissa1, Stephanie Wong1,
Anna Lane1 and Benjamin Bossard1
1 OTG Research & Consultancy, London, United Kingdom
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2 School of Life and Health Sciences, Aston University, Birmingham, United
Kingdom
Commercial Relationships: Michel Guillon, Johnson & Johnson Vision Care (C), Alcon (C), Allergan
(C), OTG Research & Consultancy (F), Wipes / Optometric technology Group Ltd (P), Contact Lens
Anterior Eye (S), Eye and Contact lens (S), International society for Contact Lens Research (S), Tear Film
and Ocular Surface (S), Alcon (F); Cecile Maissa, Alcon (F), Optometric Technology Group (E), Alcon
(C), Allergan (C), JJVCI (C), Member of CLDW Tear film subcommittee (Tear Film & Ocular Surface
Society) (S), Wipes/Optometric Technology Group Ltd (P); Stephanie Wong, Optometric Technology
Group (E), Alcon (F); Anna Lane, Optometric Technology Group (E), Alcon (F); Benjamin Bossard,
Optometric Technology Group (E)
Support: None
Abstract
Purpose:The International Workshop on Meibomian Gland Dysfunction has identified heat delivery to the
eyelid margin and eyelid massage as the first step in managing MGD of any severity. A difficulty in the
past has been to deliver controlled heat to the eyelid margin area. The objective of the investigation was
therefore to test the recommendation put forward by assessing the efficacy of the combined use of
controlled heat and eyelid massage.
Methods:Two sequential devices were used: EyeGiene® (to produce controlled heat to the eyelid
margins) and Supranettes™ eye cleaning wipes (to deliver eyelid massage): twice a day for three weeks
and once a day for the reminder of the three month management. The population was eleven dry eye
sufferers with MGD defined by a positive OSDI score (Total score 13) and at least Grade 2 eyelid margin
anomalies. The primary endpoints were subjective response with the OSDI, tear film stability measured
with the Tearscope and tear film lipid composition measured by HPLC.
http://abstracts.iovs.org/cgi/content/abstract/54/6/6044
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3/29/2015
Effects of controlled heat delivery to the eyelid margin & eyelid hygiene on symptomatology and the tear film in MGD ­­ Guillon et al. 54 (6): 6044 ­­ ARV…
Results:The results showed that: i. The average OSDI score decreased from "severe" pre­treatment
(Total=39.5) to "moderate" at the three week (Total=24.8; p=0.031) and three month (Total=26.6;
p=0.038) follow­up. At three months the incidence of severe cases was halved (73% vs. 36%) and the
incidence of "asymptomatic" cases nearly one in five (0% vs. 18%). ii. Tear film stability increased
significantly between pre­treatment (Med 7.7sec) and the three week (Med 12.7sec; p=0.045) and three
month (Med 11.3; p=0.004) follow­up. iii. Total tear film lipid concentration increased significantly from
pre­treatment (3.3µg/µl) to the three week (5.8 µg/µl; p=0.079) and three month (7.4 µg/µl; p=0.032)
follow­up. iv. Tear film lipid composition was altered during the study period. After three months
concentrations of fatty acids (12.6% vs. 7.2%; p=0.033) and cholesterol (1.4% vs. 0.9%; p=0.038)
decreased and concentrations of wax ester/cholesterol ester (85.4% vs. 90.6%; p=0.039) and triglycerides
(0.5% vs. 1.3%; p=0.013) increased.
Conclusions:The study demonstrated the efficacy of the combined use of controlled heat and mechanical
massage in reducing symptoms in MGD. Further, the results suggest that this controlled management
affect the meibomian glands as the tear film lipid concentration increased, and its composition was
modified leading to improved tear film stability.
Keywords: 486 cornea: tears/tear film/dry eye • 526 eyelid • 583 lipids
© 2013, The Association for Research in Vision and Ophthalmology, Inc., all rights
reserved. Permission to republish any abstract or part of an abstract in any form must be
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