April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Forceful Meibomian Gland Expression With A Standardized Force Of 8 PSI On Patients With Obstructive Meibomian Gland Dysfunction
Author Affiliations & Notes
  • Samuel Kim
    TearScience, Morrisville, North Carolina
  • Caroline A. Blackie
    Tear Science, Boston, Massachusetts
  • Donald R. Korb
    Korb Associates, Boston, Massachusetts
  • Footnotes
    Commercial Relationships  Samuel Kim, TearScience (E); Caroline A. Blackie, TearScience (E); Donald R. Korb, TearScience (I, P)
  • Footnotes
    Support  TearScience Inc. and Korb Associates
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 3819. doi:
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      Samuel Kim, Caroline A. Blackie, Donald R. Korb; Forceful Meibomian Gland Expression With A Standardized Force Of 8 PSI On Patients With Obstructive Meibomian Gland Dysfunction. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3819.

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

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Purpose: : To determine the nature of meibomian gland (MG) material expressed when a standardized force of 8 PSI is used.

Methods: : Eligible patients recruited for an IRB approved study were fully consented and enrolled (n=36; 23 females; 13 males). Eligible patients had dry eye symptoms recorded on the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire ≥ 6 in each eye. Evidence of obstructive MGD was determined using standardized instrument which exerts ~0.3 PSI over the MGs of the lower lid (MG score ≤ 12 on each eye, maximum score = 45 if all glands functional). Five glands in each third of the lower lid (total for each lid = 15 glands) were expressed and scored. A slit lamp examination was used to determine the presence or absence of obvious signs of MGD. Standardized instrumentation which exerts ~8 PSI over the lower lid MGs was used for a period of 10 seconds (in conjunction with a Mastrota paddle to protect the eyeball), to express the non-liquid MG contents from 15 glands along lower lid (5 glands in each third of the lid). The nature of the expressed material was documented and scored as follows: no secretion = 0, inspissated filamentary material = 1, columnar inspissated material = 2, globular liquid = 3 and liquid. Data are presented for right eyes only.

Results: : The mean age of the patients = 50.33±14.14. The slitlamp examination revealed that 53% of the patients had obstructive MGD that was nonobvious. The mean MG score prior to the forceful expression = 6.8±3.8. The forceful expression with 8 PSI revealed the following: the majority of the glands, 50.9%, did not release any secretion during the 10 second expression, 11.5% of the secretions were filamentary inspissated, 11.9% were columnar inspissated, 11.1% were globular and 14.6% were liquid.

Conclusions: : This is the first report standardizing the amount of pressure used in forceful MG expression and the first to describe the nature of the MG contents under standardized forceful expression.

Keywords: cornea: tears/tear film/dry eye 

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