September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Daily Warm Compress Therapy Augmented with Manual Lid Expressions vs a Single Thermal Pulsation System Treatment for Evaporative Dry Eye Disease Secondary to Meibomian Gland Dysfunction
Author Affiliations & Notes
  • Andrew T McPherson
    Schepens Eye Research Institute, Boston, Massachusetts, United States
  • Rina Wu
    Schepens Eye Research Institute, Boston, Massachusetts, United States
  • Paula Oliver
    Schepens Eye Research Institute, Boston, Massachusetts, United States
  • Jerome A Pullen
    Schepens Eye Research Institute, Boston, Massachusetts, United States
  • Jack V Greiner
    Schepens Eye Research Institute, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Andrew McPherson, None; Rina Wu, None; Paula Oliver, None; Jerome Pullen, None; Jack Greiner, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5680. doi:
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      Andrew T McPherson, Rina Wu, Paula Oliver, Jerome A Pullen, Jack V Greiner; Daily Warm Compress Therapy Augmented with Manual Lid Expressions vs a Single Thermal Pulsation System Treatment for Evaporative Dry Eye Disease Secondary to Meibomian Gland Dysfunction. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5680.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To compare dry eye signs and symptoms at 3 months following a single thermal pulsation system treatment (TPST) vs a 3-month daily application of warm compress therapy supplemented with 2 manual lid expressions (WCMLET) in dry eye patients presenting with meibomian gland dysfunction (MGD).

Methods : In this single-center observational study, signs (meibomian gland analysis [MGA] scores and tear film breakup time [TFBUT]) and symptoms (as per Ocular Surface Disease Index [ODSI] and Standard Patient Evaluation of Eye Dryness [SPEED] dry eye questionnaires) were determined at baseline (BL) and 3-months for (1) MGD patients (n=15; 30 eyes) receiving a single TPST or (2) MGD patients (n=15; 30 eyes) practicing daily warm compress therapy over 3 months plus 2 manual lid expressions, each separated by 6-8 weeks. There was no difference in the mean age between groups (p>0.05).

Results : The more severely symptomatic individuals opted for inclusion in the TPST group. The 3-month WCMLET protocol reduced symptoms (SPEED BL 11.9±1.4 [mean±SE] vs 3 months 7.73±1.2; p<0.01. OSDI BL 22.35±4.4 vs 3 months 11.88±3.3; p<0.01) and signs (MGA score BL 17.9±2.1 vs 3 months 25.93±1.5; p<0.01). A single 12-min TPST reduced symptoms (SPEED BL 14.53±1.7 vs 3 months 10.76±1.8; p<0.04. OSDI BL 35.61±5.7 vs 3 months 23.86±4.5; p<0.04) and signs (MGA score BL 15.5±1.6 vs 3 months 23.79±2.6; p<0.01). No significant change was noted in TFBUT for either group at the 3 month time-point vs BL (p>0.05).

Conclusions : Both WCMLET and TPST significantly reduced dry eye signs and symptoms, although WCMLET required a daily patient commitment over a 3-month period including multiple office visits whereas TPST involved a onetime office visit. Although a selection bias was created by the fact that the most symptomatic individuals preferred inclusion in the TPST group, this suggests that symptom severity may be a driving factor in overcoming the perceived financial barrier of a single TPST vs the more labor-intensive and time-consuming commitment to a WCMLET regimen. It is noteworthy that TFBUT was not a reliable objective clinical sign for monitoring the degree of symptomatic improvement following dry eye disease intervention, at least for the 3-month evaluation point reported herein.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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