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Charles G Connor, Srihari Narayanan, Sandra Fortenberry, Narges Kasraie, Karim Sayani, Eliana Pelfrey, William L Miller; Effect of lid margin debridement on MGD and inflammatory marker MMP-9. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6730.
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© ARVO (1962-2015); The Authors (2016-present)
Meibomian Gland Disease (MGD) is a common cause of evaporative dry eye. Office-based management options for MGD offer better success than home-based options. Korb demonstrated relief in MGD signs and symptoms using debridement-scaling. We showed (ARVO 2015, 2017) that lid margin debridement improves MGD signs and symptoms and decrease ocular surface inflammatory marker MMP-9. The LidPro allows lid debridement without using a surgical instrument. The InflammaDry recognizes elevated levels of MMP-9. The purpose of this study is to determine if MGD signs and symptoms and MMP-9 levels change following lid margin debridement with the LidPro.
Twenty five MGD patients (6 male,19 female) with evaporative dry eye (Age range 22 to 66 years; mean age 30.68+/- 12.3 years) participated in this study. The OSDI, Non invasive tear break-up time (NITBUT), Meibography grading and Inflammadry test were done just prior to LidPro treatment. All tests were repeated two weeks post-treatment. Data was analyzed by a t-test with post hoc test for significance.
Subjects reported an improvement of ocular surface comfort for an average of 5.4 days +/- 5.03 days after LidPro treatment. At two weeks following treatment, though the OSDI scores decreased from baseline (30.92 +/- 20.62 to 23.69 +/- 18.54) and the NITBUT increased (6.81 +/- 2.7 seconds to 7.06 +/-2.59 seconds), these were not statistically significant. Meibography (Pult grading scheme; Oculus 5M Keratograph) did change significantly (pre-treatment Grade 1.91 to grade 1.20 post-treatment p=0.01). The MGD Efron grading improved from 1.9 to 1.44 p=0.01. While 19 subjects were MMP-9 positive pre-treatment, only 4 became negative at post-treatment.
Lid margin debridement with LidPro resulted in a very short-term benefit to ocular surface comfort as well as improvement in signs such as Meibography grades and MGD Efron grading scores. MMP-9 marker was negative post-treatment in very few patients. The lack of use of a cleaning agent with the LidPro may have decreased the efficacy of the technique. Based on our previous data (ARVO 2015, 2017), other methods of lid margin debridement offer longer term benefits.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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