Evaluation of Single Thermal Pulsation Treatment for Meibomian Gland Dysfunction and Dry Eye

Sunday, April 19, 2015: 8:37 AM
Room 1B (San Diego Convention Center)
Alice T. Epitropoulos, MD, FACS

Purpose
Evaporative dry eye from meibomian gland dysfunction (MGD) is the most common form of dry eye. LipiFlow (thermal pulsation, Tearscience) is the only FDA approved treatment for Evaporative Dry Eye. We sought to assess if LipiFlow improves subjective and objective variables relating to dry eye and MGD.

Methods
This is a retrospective study of patients who received a single Lipiflow treatment between 10/2013-08/2014.  Preoperative symptom scores, tear breakup time (TBUT), and MG Evaluation Score (MGES) were obtained from eligible patient records. The same measures and subjective symptom comments were obtained 6-8 weeks postoperatively. The Wilcoxon matched-pairs signed rank test was used to compare preoperative and postoperative symptom and MGES scores. Male and female outcomes were compared with the Mann Whitney test.  Preoperative and postoperative TBUT was compared with paired t-test.

Results
Eighty-two eyes, of 14 males and 37 females, (51 patients) were studied. The average age was 63.5±12.8 years. There was a statistically significant difference (p<0.05) between preoperative and postoperative symptom scores (16.0±7.3 to 11.0±6.1), TBUT (4.0±3.4 to 7.3±4.3), and MGES (3.0±3.3 to 14.0±8.9). Further, while there was no preoperative difference (p=0.123), females experienced a greater reduction in symptoms v. males postoperatively (p=0.0425). Eightly-six percent of patients experienced a reduction in symptoms post treatment.

Conclusion
This study demonstrates the effectiveness of a single 12-minute thermal pulsation treatment with the LipiFlow in patients with dry eye from MGD. The efficacy is evidenced by the improvement in postoperative symptom and MG expression scores and TBUT.