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A. Shapiro, M. Abelson, D. Welch, D. Touhey; An Evaluation of the Meibomian Gland Secretion Refractory Period. Invest. Ophthalmol. Vis. Sci. 2008;49(13):84.
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To evaluate the normal meibomian gland refractory period in subjects with meibomitis.
Subjects with meibomitis were evaluated at 4 visits over 3 weeks. Meibomitis was clinically diagnosed by abnormal secretion quality, including increased viscosity and decreased clarity. At each visit meibomian gland provocation was performed twice. The second provocation occured at 30 minutes (Visit 1), 1 hour (Visit 2), 2 hours (Visit 3) and 4 hours (Visit 4) following the first provocation. The percentage of meibomian glands eliciting a secretion during the second provocation was calculated. A high magnification, digital slit lamp was used to observe, track and document the individual meibomian gland secretions.
A total of 6 subjects were enrolled in the study. A total of 53 meibomian glands were identified and followed. 54.7%, 68.0%, 73.6% and 66.7% of meibomian glands were able to elicit a secretion 30 minutes, 1 hour, 2 hours and 4 hours after initial provocation, respectively.
Understanding the meibomian gland refractory period is important in designing clinical trials evaluating meibomian gland health. In order to appropriately determine the volume and quality of meibomian gland secretions it is important to establish an appropriate wait period prior to meibomian gland provocation during which the eyelids are not touched. In this study the optimal meibomian gland refractory period was 2 hours.
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