Efficacy of Meibomian Gland Intraductal Probing for the Treatment of Meibomian Gland Dysfunction

Abstract

Purpose : To determine if there are improvements in the signs and symptoms of ocular surface disease after meibomian gland probing in patients with meibomian gland dysfunction (MGD).

Methods : A retrospective cohort study of patients with a diagnosis of MGD who underwent treatment with the meibomian gland intraductal probing between November 2016 and February 2017 at a single large academic institution was performed. Forty eyes from twenty subjects were included. Symptoms were assessed using the Ocular Surface Disease Index (OSDI). Ocular surface staining with fluorescein and lissamine green was performed. Infrared meibography images were obtained before and after probing and were subjectively and objectively analyzed. Paired t-test was used for comparing the pre- vs. post-treatment person-level OSDI score. A generalized linear model was used for comparing the pre- vs. post-treatment eye-level sign measures and the inter-eye correlation was accounted for by using generalized estimating equations.

Results : The mean age of 20 patients was 67 years (range: 57-80 years), with a mean follow-up of 43 days. The OSDI score post-treatment improved for 83% of patients (8 of 12 subjects with OSDI scores) with an overall mean improvement of 9.4 points, which was statistically significant (p = 0.004, 95% CI [-15, -3.8]). However, there was no change in the overall mean lissamine green conjunctival staining (p=1.00, 95% CI [-0.29, 0.29]) or corneal staining with fluorescein (p = 0.87, 95% CI [-0.16, 0.19]) (Table 1). A subgroup analysis was performed on the 10 patients who did not have any missing data and similar results were obtained. The procedure was well tolerated without complications. Recurrence of ocular surface symptoms was seen in 6 of 14 patients with 1 reporting an exacerbation of symptoms after the procedure. Grading and analysis of meibography images is still ongoing and these results will be presented.

Conclusions : In this small series, meibomian gland intraductal probing was found to be easy-to-use, safe, and well-tolerated. There was a significant improvement in symptoms in the majority of patients, but there was no significant change in ocular surface staining. Meibomian gland probing may be beneficial in relieving symptoms in patients with MGD. Future clinical trials with longer follow-up times are needed to confirm these benefits.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.