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Pam Satjawatcharaphong; Effects of LipiFlow treatment on dry eye symptoms, tear film stability, and meibomian gland expression 1Pam Satjawatcharaphong, 1Yixiu Zhou, 1,2Meng C. Lin 1. UC Berkeley, School of Optometry, Clinical Research Center 2. UC Berkeley, Vision Science Graduate Group. Invest. Ophthalmol. Vis. Sci. 2014;55(13):32.
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To assess changes in dry eye symptoms, lipid layer thickness, tear film stability, and meibomian gland expressibility after treatment with the LipiFlow® Thermal Pulsation System.
23 patients (34 eyes) were treated with the LipiFlow® Thermal Pulsation System and completed a follow-up visit 6 to 10 weeks after treatment. Lipid layer thickness (LLT) was determined using the LipiView® Interferometer. Non-invasive tear breakup time (NITBUT) was measured using a Medmont E300 Corneal Topographer. Invasive tear breakup time (ITBUT) with fluorescein dye as well as corneal and conjunctival staining were assessed with slit lamp biomicroscopy. Meibomian gland expressibility (MGE) was performed and scored using the TearScience Meibomian Gland Evaluator, and meibography was imaged using the Oculus Keratograph. These measurements were taken prior to treatment and repeated at a follow-up visit.
The average SPEED score after treatment was decreased from 15±5 to 9±4 in 24 eyes (71%). Patients with unstable tear film prior to treatment showed a significant decrease in SPEED score (p=0.049), whereas patients with stable tear film had a marginally significant decrease in SPEED score (p=0.073). Average NITBUT was not significantly changed after treatment for the entire sample of patients; however, patients with unstable baseline tear film NITBUT exhibited significant improvement (i.e., longer NIBUT) after treatment (p=0.031). The average MGE score was significantly improved in the lower lid for all patients (p=0.090), and specifically improved for patients with unstable tear film (p=0.013). After treatment, 16 eyes (47%) were found to have MGE in the lower lid improved from 7±5 to 19±9. There was no significant change in post-treatment ITBUT, LLT and meibography.
Overall, patients demonstrated improvement in symptoms, tear film stability, and meibomian gland expressibility after LipiFlow® treatment; however, the changes were most significant in patients who initially presented with unstable tear film assessed by NITBUT. LLT values of our sample patients were not related to improvement in gland expressibility and dry eye symptoms.
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