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Naohiko Nakayama, Motoko Kawashima, Minako Kaido, Reiko Ishida, Reiko Arita, Sachiko Inoue, Kazuo Tsubota; Analysis of Meibum Before and Following Intraductal Meibomian Gland Probing for Eyes with Obstructive Meibomian Gland Dysfunction. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3051.
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© ARVO (1962-2015); The Authors (2016-present)
Obstructive meibomian gland dysfunction (o-MGD) is a common lid margin disorder which causes a sense of stubborn eye discomfort, yet our current symptomatic treatment is often ineffective. Intraductal meibomian gland probing, an invasive orifice penetration and intraductal probing was previously reported to alleviate symptoms of o-MGD, although its effect on the meibum has not been described. We hypothesize that this intervention increases the amount of lipid flow and thus yields improvement in the ocular symptoms.
Patients with o-MGD, which was refractory to conventional management underwent intraductal meibomian gland probing. Meibum and clinical outcome were evaluated before the procedure and at the 1-month postoperative visits. Meibum analysis was performed by the Meibometer®, which can quantify lipid volume objectively. The condition of tear film was evaluated by DR1 and meibomian gland loss was analyzed by noncontact infrared meibography. Lid margin findings (tarsal hyperemia, telangiectasia, mucocutaneous junction, plugging, thickening or irregularity), tear break-up time (BUT), fluorescein score, meibum viscosity (Shimazaki grade) and ocular symptoms were also assessed.
Six lid margins of three refractive o-MGD eyes underwent intraductal meibomian gland probing. There were no complications. At the postoperative visits, all cases showed improvement of meibum lipid levels (446 to 1376, 757 to 802, 396 to 571 meibometer units, respectively) and meibum viscosity (grade 3 to 0, 3 to 1, 3 to 2, respectively). Two cases showed an improvement of tear BUT (2 to 5, 0 to 6 sec, respectively). Morphological change of the meibomian gland was not observed in any cases.
Intraductal meibomian gland probing seems to provide improvement of lipid levels of the meibomian glands, and it is an effective and promising treatment for o-MGD resistant to conventional treatment.
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