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D. Su, A. Schwartz, E. Elahi; Use of Monopolar Radiofrequency in Treating Blepharitis and Associated Meibomian Gland Dysfunction. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5361.
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© ARVO (1962-2015); The Authors (2016-present)
Monopolar radiofrequency has been described to be effective in management of acne vulgaris. We wished to determine if a similar effect would be observed in the treatment of blepharitis and meibomian gland dysfuntion. Thermage is a radiofrequency device currently used for non-invasive skin tightening and contouring.
Five patients with blepharitis were recruited for prospective split-face pilot study. The side with worse symptoms received radiofrequency treatment while the other side served as control. A questionnaire was provided to each patient to evaluate subjective clinical symptoms. Each symptom was graded on a scale of 0 to 4 with 4 being the most severe. A total of seven symptoms were assessed. The following tests were administered before treatment, 2 weeks after, and 6 weeks after treatment: Schirmer’s test, tear break up time, meibum expression, and meibography. Meibum expression and meibography were scored on a scale of 0-2 with 2 being the most severe. The radiofrequency treatment was delivered using the Thermage NXT system. Shallow penetration 0.25 cm² tips were used with an average of 4 to 5 passes per eyelid at an average energy level of 56 J/cm².
Mean symptoms scores decreased over the course of 6 weeks after treatment from 12.5 to 6.0. Schirmer test mean wetting length increased from 7.0 mm before treatment to 9.0 6 weeks after treatment. Mean tear break up time (sec) was 15.5 before treatment, 13.5 2 weeks after, and 10.0 6 weeks after. Mean meibomian gland obstruction scores stayed relatively constant throughout, and mean meibography score stayed constant.
While the number of patients involved in the study is far too limited for a statistically significant conclusion, a number of parameters were shown to improve as a result of radiofrequency treatment. It is possible that radiofrequency treatment may provide an additional clinical tool in the treatment of blepharitis. Further studies using larger patient populations are required to assess the effectiveness of this treatment.
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