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David Finis, Claudia König, Jasmin Hayajneh, Maria Borrelli, Stefan Schrader, Gerd Geerling; Implications of Meibominan Gland Atrophy on the Efficacy of Lipiflow® treatment. Invest. Ophthalmol. Vis. Sci. 2014;55(13):33.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the implications of meibomian gland atrophy on the efficacy of a single Lipiflow® treatment.
In this retrospective chart review of 26 subjects with MGD we analyzed the data 6 months after a single Lipiflow®-treatment. Investigated parameters included subjective symptoms (OSDI, SPEED), lipid layer thickness (LLT, Lipiview®), Meibomian gland assessment (Meibomian-Gland-Evaluator®), tear osmolarity (Tearlab®), corneal and conjunctival staining (Oxford-scale), Lid margin parallel conjunctival folds (LIPCOFs) and Schirmer test values. Bulbar redness (R-score), tear meniscus height, Meibomian gland atrophy (meibography) and noninvasive tear break-up time (NIBUT) were measured with the Oculus Keratograph 5M®.
The results showed a significant reduction of subjective symptoms (mean OSDI 42 ± 19 to 33 ± 21; p < 0.005, mean SPEED 16 ± 7 to 12 ± 7; p < 0.001), an improvement of LLT (44.0 ± 15.6 to 51.3 ± 20.4; p < 0.05), increase of expressible glands (2.9 ± 1.6 to 6.4 ± 4.6; p < 0.0001), decrease of LIPCOFs (2.3 ± 1.0 to 2.0 ± 0.9; p < 0.05), as well as bulbar redness (1.4 ± 0.5 to 1.2 ± 0.5; p < 0.001) six month after a single Lipiflow® treatment. Patients with severe Meibomian gland atrophy (drop out ≥ 2/3 of all glands) evaluated by meibography did respond poorly to the treatment compared to the patients with less drop out (mean change in OSDI -10.1 ± 15.4 vs. -3.0 ± 6.9; p < 0.05).
In summary the results show that a single Lipiflow® treatment is effective in the treatment of MGD. However, a meibography should be performed before treatment to exclude potential non-responders.
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