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Arjan Hura, Alice Epitropoulos, Craig Czyz, Caroline A Blackie, Tracy Davis (McClelland); The potential effect of LipiFlow on meibomian gland structure: a preliminary analysis utilizing Dynamic Meibomian Imaging. Invest. Ophthalmol. Vis. Sci. 2018;59(9):935.
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© ARVO (1962-2015); The Authors (2016-present)
Most patients with dry eye disease (DED) have meibomian gland dysfunction (MGD) as a primary or contributory cause of DED. Obstruction of meibomian glands (MG) leads to MG atrophy and it is unknown if treatment utilizing LipiFlow can reverse the atrophy. We conducted a retrospective, observational study in patients with DED and MGD comparing visible gland structure (VGS) with LipiView II Dynamic Meibomian Imaging (DMI) along with other DED markers (DEDM). We hypothesized that we would find improved MG function and possible improvement in VGS in patients who proceeded with LipiFlow versus those who did not.
102 patients identified as having received LipiFlow therapy at least one year prior and for whom high quality DMI had been recorded pre-therapy are being brought back to have follow-up DMI and DED evaluation. DEDMs such as tear break up time, corneal staining, tear osmolarity, MMP-9, meiboscale, and MG slit lamp evaluation are being compared pre- and post-LipiFlow therapy. Morphometric analysis on pre- and post-therapy DMI is being analyzed for change in VGS. Data is being compared against a control group of patients with DED who received DMI and a recommendation for LipiFlow, but never proceeded with LipiFlow therapy.
Data collection is complete for 14 eyes. Following treatment, SPEED scores decreased by 4.6 points (p = 0.006; CI = -7.4, -1.8), TBUT increased by 3.9 seconds (p = 0.018; CI = 0.79, 7), and MG slit lamp evaluation improved by 9.8 points (p = 0.001; CI = 4.8, 15). Of 14 initial eyes, 0% showed no difference in VGS post-therapy, 35.7% showed a decline ≤ 5%, and 7.1% showed a decline > 5%. 35.7% of eyes showed an improvement in VGS ≤ 5%, 14.2% showed improvement between 5-10%, and 7.1% showed improvement > 10%.
Initial results are consistent with the hypothesis that LipiFlow therapy stabilized or improved VGS in a majority of patients. Additionally, some patients showed improvement in appearance of MGs with an associated long-term improvement in other DEDMs. Further research is needed to definitively determine if LipiFlow therapy can reverse gland atrophy and potentially restore MG function in previously atrophied glands.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Red = total area analyzed; Green = borders of MGs; Green arrows = areas of presumptive improvement
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