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Graham Stetson, Christen Kenrick; A comparison of four warm compress devices. Invest. Ophthalmol. Vis. Sci. 2018;59(9):953.
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© ARVO (1962-2015); The Authors (2016-present)
Eyelid warming treatments have become popular therapies for meibomian gland dysfunction. This study compared the ability of 4 commercially available lid heating devices to increase eyelid temperature and tear film lipid layer thickness (LLT), and determined whether any device altered corneal topography.
An IRB approved, non-randomized, prospective study enrolled nine adult female subjects without ocular disease. A single treatment to one eye with one of the following warm compress devices was completed at each visit: Bruder Moist Heat Eye Compress, Thea Blephasteam, MiBo ThermoFlo, and LipiFlow. For each treatment we measured corneal topography, lipid layer thickness, and temperatures of the inner and outer, upper and lower eyelids at baseline and again after treatment. Treatments were separated by an average of 31 days.
The MiBo ThermoFlo raised the outer upper and lower eyelid temperatures 0.52 °C and 0.56 °C, and the inner upper and lower eyelid temperatures 1.13 °C and 1.19 °C. The Bruder device raised the outer upper and lower eyelid temperatures 1.88 °C and 1.49 °C, and the inner upper and lower eyelid temperatures 1.69 °C and 1.56 °C. The Blephasteam raised the outer upper and lower eyelid temperatures 1.07 °C and 0.63 °C, and the inner upper and lower eyelid temperatures 1.78 °C and 1.44 °C. The LipiFlow raised the outer upper and lower eyelid temperatures 1.71 °C and 0.91 °C, and the inner upper and lower eyelid temperatures 2.11 °C and 2.32 °C.The average difference in LLT after treatment for the MiBo ThermoFlo was +0.89nm. For the LipiFlow, the difference was +15.00nm. For the Blephasteam, the difference was +19.00nm. The Bruder device showed an average difference in LLT of +20.67nm. None of the four devices caused significant alteration of corneal curvature, magnitude of astigmatism, astigmatism axis, or eccentricity.
All devices tested raised the temperature of the inner eyelids but not by equal amounts. LipiFlow heated the inner eyelids more than the other devices. The post treatment increase in LLT was similar with the Bruder device, Blephasteam and LipiFlow, while the MiBo ThermoFlo had the smallest LLT increase. LipiFlow expresses and removes meibum, and the ThermoFlo requires application of ultrasound gel to the lids. The LLT values need to be interpreted in this context. Neither of these devices altered corneal topography metrics.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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