Patient Characteristics Associated With Improved Meibomian Gland Function After Thermal Pulsation Treatment for Meibomian Gland Dysfunction
Purpose
To assess the patient demographic and baseline characteristics associated with short-term and long-term improvement in meibomian gland function after a single, in-office thermal pulsation treatment(LipiFlow System), which applies simultaneous heat and pressure to the eyelids for treatment of meibomian gland dysfunction (MGD).
Methods
A single 12-minute thermal pulsation treatment was administered to 99 subjects (197 eyes) in a prospective, multicenter, open-label clinical trial. Inclusion criteria included evidence ofMGD based on a meibomian gland (MG) secretion score ≤ 12 and dry eye symptoms based on a questionnaire score ≥ 13. MG secretion score was assessed at baseline and after treatment at 1 Month, 3 Months, 6 Months, 9 Months and 12 Months. Patient characteristics associated with change in MG secretion from baseline were evaluated in univariate and multivariate models with repeated measures while accounting for potential correlations between subject eyes and across visits.
Results
Mean MG secretion score improved from baseline (6.3 ± 3.7) to after treatment at 1 month (17.3 ± 11.2), 3 months (17.8 ± 10.6), 6 months (18.7 ± 10.9), 9 months (18.8 ± 9.8) and 12 months (17.3 ± 9.1). While several patient characteristics (e.g., history of chalazia and dry eye symptom duration) were significantly associated (p<0.05) with change in MG score in univariate models, only baseline MG score and duration of MGD diagnosis remained significant in multivariate model from baseline to 3 months. In repeated measures, multivariate model across all visits through 12 months, baseline MG score was significant.
Conclusion
Mean improvement in meibomian gland function was observed for up to one year after a single thermal pulsation treatment for MGD. Patient characteristics related to less severity of MGD and shorter duration of MGD diagnosis were significantly associated with greater improvement in meibomian gland function after treatment.