Abstract
Purpose :
To compare dry eye signs and symptoms at 3 months following a single thermal pulsation system treatment (TPST) vs a 3-month daily application of warm compress therapy supplemented with 2 manual lid expressions (WCMLET) in dry eye patients presenting with meibomian gland dysfunction (MGD).
Methods :
In this single-center observational study, signs (meibomian gland analysis [MGA] scores and tear film breakup time [TFBUT]) and symptoms (as per Ocular Surface Disease Index [ODSI] and Standard Patient Evaluation of Eye Dryness [SPEED] dry eye questionnaires) were determined at baseline (BL) and 3-months for (1) MGD patients (n=15; 30 eyes) receiving a single TPST or (2) MGD patients (n=15; 30 eyes) practicing daily warm compress therapy over 3 months plus 2 manual lid expressions, each separated by 6-8 weeks. There was no difference in the mean age between groups (p>0.05).
Results :
The more severely symptomatic individuals opted for inclusion in the TPST group. The 3-month WCMLET protocol reduced symptoms (SPEED BL 11.9±1.4 [mean±SE] vs 3 months 7.73±1.2; p<0.01. OSDI BL 22.35±4.4 vs 3 months 11.88±3.3; p<0.01) and signs (MGA score BL 17.9±2.1 vs 3 months 25.93±1.5; p<0.01). A single 12-min TPST reduced symptoms (SPEED BL 14.53±1.7 vs 3 months 10.76±1.8; p<0.04. OSDI BL 35.61±5.7 vs 3 months 23.86±4.5; p<0.04) and signs (MGA score BL 15.5±1.6 vs 3 months 23.79±2.6; p<0.01). No significant change was noted in TFBUT for either group at the 3 month time-point vs BL (p>0.05).
Conclusions :
Both WCMLET and TPST significantly reduced dry eye signs and symptoms, although WCMLET required a daily patient commitment over a 3-month period including multiple office visits whereas TPST involved a onetime office visit. Although a selection bias was created by the fact that the most symptomatic individuals preferred inclusion in the TPST group, this suggests that symptom severity may be a driving factor in overcoming the perceived financial barrier of a single TPST vs the more labor-intensive and time-consuming commitment to a WCMLET regimen. It is noteworthy that TFBUT was not a reliable objective clinical sign for monitoring the degree of symptomatic improvement following dry eye disease intervention, at least for the 3-month evaluation point reported herein.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.