Thermal Pulsation Treatment for MGD and Dry Eye to Optimize Tear Film for Better Quality of Vision After Laser Refractive Surgery or Advanced Technology Lens Implantation

Sunday, April 19, 2015: 9:00 AM
Room 1B (San Diego Convention Center)
Barbara Kusa, MD
Matteo Piovella, MD

Purpose
To evaluate a new system for the thermal pulsation treatment of meibomian gland dysfunction(MGD) in evaporative dry eye patients.

Methods
Sixty-four eyes of 33 patients (mean age 51.84 ± 16.39 years) were diagnosed with MGD based on the following criteria: results of a symptom questionnaire and quantification of the lipid layer thickness using interferometric color units (ICU) as determined by the LipiView (TearScience) and standardized meibomian gland expression to determine meibomian gland functionality. Criteria for treatment eligibility were LipiView score ≤ 70 ICU and meibonian gland function evaluation. Eligible patients received a LipiFlow treatment (TearScience) designed to remove meibomian gland obstructions and restore meibomian gland function. Patients were reassessed - at 1-3-6 months  - 1year and 2 years post treatment.

Results
In all eyes, the symptoms had decreased at 1 month post-treatment. The mean pre-treatment ICU score is increased from 52.13 ± 19.50 to 91.75 ± 14.57  at 2 years post-treatment. The AVG ICU showed 76% increase. Patients reported no discomfort or pain during or after treatment.

Conclusion
This new system provides an effective and efficient means of treatment for meibomian gland dysfunction and evaporative dry eye. For patients with MGD, this treatment should be considered prior to laser assisted refractive surgery or advanced technology lens implantation in order to optimize the tear film and thus optimize surgical outcomes.