July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
The potential effect of LipiFlow on meibomian gland structure: a preliminary analysis utilizing Dynamic Meibomian Imaging
Author Affiliations & Notes
  • Arjan Hura
    Riverside Methodist Hospital, Columbus, Ohio, United States
  • Alice Epitropoulos
    Ophthalmic Surgeons & Consultants of Ohio Inc, Columbus, Ohio, United States
    The Eye Center of Columbus, Columbus, Ohio, United States
  • Craig Czyz
    Ophthalmology, Section Oculofacial Plastic and Reconstructive Surgery, Ohio University/OhioHealth Doctors Hospital, Columbus, Ohio, United States
    Ophthalmology, Oral and Maxillofacial Surgery, Grant Medical Center, Columbus, Ohio, United States
  • Caroline A Blackie
    Vision, Johnson & Johnson, Morrisville, North Carolina, United States
  • Tracy Davis (McClelland)
    Ophthalmic Surgeons & Consultants of Ohio Inc, Columbus, Ohio, United States
    The Eye Center of Columbus, Columbus, Ohio, United States
  • Footnotes
    Commercial Relationships   Arjan Hura, Johnson & Johnson Vision (F); Alice Epitropoulos, Johnson & Johnson Vision (F), Johnson & Johnson Vision (C); Craig Czyz, Johnson & Johnson Vision (F); Caroline Blackie, Johnson & Johnson Vision (E), Johnson & Johnson Vision (S); Tracy Davis (McClelland), None
  • Footnotes
    Support  Johnson & Johnson Vision Investigator Initiated Study
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 935. doi:
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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)

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Abstract

Purpose : 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.

Methods : 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.

Results : 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%.

Conclusions : 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

Red = total area analyzed; Green = borders of MGs; Green arrows = areas of presumptive improvement

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