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M.C. Olson, D.R. Korb, J.V. Greiner; Evaluation of Warm Compress Therapy for Meibomian Gland Dysfunction . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2452.
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Purpose: The purpose of this study is to evaluate the effects of warm compress therapy on tear film lipid layer thickness (TFLLT) in subjects with meibomian gland dysfunction (MGD). Methods: Subjects (n=10) with a diagnosis of dry eye associated with MGD, and a baseline TFLLT of ≤ 90 nm (baseline difference between control and test eyes ≤ 25 nm) were studied. The skin of the closed eyelids of the experimental eye of each subject was treated for a total of 10 min with a linen cloth saturated with warm (40.0 ± 2.0oC) water used as a compress gently applied to the skin. The skin of the closed eyelids of the contralateral control eye was treated for a total of 10 min with an identical linen cloth saturated with ambient room-temperature (24.0 ± 1.0oC) water used as a compress. The choice of experimental and control eyes was randomized. TFLLT was measured after 5 min and 10 min of the treatment period using a custom designed tear film apparatus (Korb et al. Cornea 1994;13:354). Results: The mean baseline TFLLT of the experimental eye prior to treatment with a warm, moist compress was 57 ± 20.9 (S.D.) nm; after 5 min treatment, TFLLT was 127.5 ± 33.4 nm; and after 10 min treatment, 142.5 ± 22.6 nm. The mean baseline TFLLT of the control eye prior to treatment with an ambient room-temperature, moist compress was 57 ± 21 nm; after 5 min treatment, TFLLT was 61.5 ± 40.9 nm; and after 10 treatment, 61.5 ± 40.9 nm. Using a paired data t-test, the results for the experimental eye demonstrated a significant increase in mean TFLLT after 5 min (p < 0.0001) and 10 min (p < 0.0001) of compress treatment when compared to baseline TFLLT. However, there was no statistically significant increase in TFLLT for the experimental eye after 10 min treatment when compared to after 5 min (p = 0.13) treatment. For the control eye, there was no significant increase in TFLLT after 5 min (p = 0.38) and 10 min (p = 0.38) of compress treatment when compared to baseline TFLLT of the control eye. Conclusions: Warm, moist compress therapy applied to the skin of the closed eyelids increased TFLLT for subjects with MGD by more than 120% five min after initiating treatment, but only increased by an additional 11% after 10 min of treatment. Therefore, 5 min of warm, moist compresses may be recommended as an effective treatment period to increase meibomian gland secretion and thus increase TFLLT. This study provides quantitative data to support the common clinical practice of using warm, moist compress therapy for the treatment of meibomian gland dysfunction.
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