By Published On: 16 April 20123.1 min read

The latest studies seem to suggest that 70% of Dry Eyes is caused by meibomian gland dysfunction (MGD).  Treating MGD can be done in the following ways:

1. Warm compresses & lid massage – by warming and massaging the lids blocked meibomian glands in the eye lids can be stimulated into producing more tear film oil.

2. Oral Doxycycline – is an antibiotic but it also has anti-inflammatory properties and is said to alter the chemistry of the meibomian oil so that it can flow better.

3. Omega 3 nutrition – has anti-inflammatory properties and also possibly alters the chemistry of the meibomian oil.

The above 3 options certainly all help but… maintenance is difficult as all three options require constant compliance.  Omega 3 supplementation can be achieved by taking fish oil capsules or by eating at least 3 servings of lightly grilled salmon per week.  Asking someone to keep a constant watch on their Omega 3 intake not only might help their Dry Eyes, it is also likely to help in preventing heart disease, control rheumatoid arthritis and reduce the risk of developing macular degeneration!

Warm compresses and lid massage even though have been shown to help rely on doing it every day and will take up over than 30 minutes of your time every day – no wonder most people just don’t  do it.  Oral Doxycycline has potential side effects, such as gastric upset and significant sunsensitivity, so keeping out of the sun becomes an issue.

LIPIFLOW a new treatment has been shown to be better than warm compresses and eye lid massage.  The big issue with Lipiflow is that it only needs to be done once every year or so to maintain the benefits – certainly beats doing something every day for every!

The quoted abstract below is a medical paper that has just been published. It clearly shows that Lipiflow is effective.  We hope to provide this unique procedure from The Eye Practice in the near future.  Stay tuned as we will blog about it as soon as it is available.

“A New System, the LipiFlow, for the Treatment of MGD
The purpose of this study was to compare how effective the new Lipiflow treatment was to the traditional warm compresses (WC).

This was a non-significant risk, prospective, open-label, randomized, crossover multicenter clinical trial. One hundred thirty-nine subjects were randomized between LipiFlow (n=69) and WC control (n=70). Subjects in the LipiFlow group received a 12-minute LipiFlow treatment and were reexamined at 1 day, 2 weeks and 4 weeks. Control subjects received a 5-minute iHeat treatment with instructions to perform the same treatment daily for 2 weeks. At 2 weeks, they crossed over (LipiFlow Crossover) and received the LipiFlow treatment. Effectiveness parameters evaluated included: meibomian gland (MG) assessment, tear break-up time (TBUT) and dry eye symptoms. Safety parameters included: adverse events, ocular health exam, ocular surface staining, intraocular pressure, visual acuity and discomfort.

LipiFlow resulted in significant improvement (P < 0.05) in MG secretion at 2 and 4 weeks (mean +/- standard deviation at baseline = 6.3 +/- 3.5; 2 weeks = 14.3 +/- 8.7; 4 weeks = 16.7 +/- 8.7); and TBUT at 2 and 4 weeks: (at baseline = 5.5 +/- 2.9; 2 weeks = 6.9 +/- 5.0; 4 weeks = 7.4 +/-5.5). There was no significant change in MG secretion or TBUT in the control group. LipiFlow resulted in a greater significant reduction in dry eye symptoms than the iHeat WC. The crossover group demonstrated similar significant improvement 2 weeks post-treatment with the LipiFlow. There was no significant difference between groups in the incidence of non-serious, device-related adverse events.

It was obvious from the collected data that the Lipiflow system was significantly more effective than warm compresses in the presence of meibomian gland dysfunction and dry eye symptoms.

Lane SS, Dubiner HB, Epstein RJ, et al. A New System, the LipiFlow, for the Treatment of Meibomian Gland Dysfunction. Cornea 2012;31:396-404”.

Comments

4 Comments

  1. dry eye compress 21 July 2012 at 4:48 pm - Reply

    I herd that cold compress is also helpful for dry eyes. Is this true?

    • Dr Jim Kokkinakis 22 July 2012 at 4:34 pm - Reply

      Are Cold compresses good for dry eyes? That is a good question. They might have a role but they would be in the minority of cases, which are not related to meibomian gland dysfunction. This is a clinical decision. If the meibomian glands are functioning properly and the dry eyes are being caused by a tear or aqueous deficiency then cold compresses might have a role to play in reducing inflammation. If the meibomian glands are blocked and the primary cause of dry eyes is lipid deficiency then warm compresses is the way to go to try and melt the solidified oils that are not being secreted into the eye to stop the evaporation – hope this makes sense.

  2. Steven 17 August 2012 at 7:49 pm - Reply

    I have MGD caused by ocular rosacea . When will this be available to Australia?

  3. Dr Jim Kokkinakis 17 August 2012 at 10:03 pm - Reply

    Hi Steven
    I am happy to say that we finally have the LipiFlow system. Over the last couple of months we have treated quite a number of people and assessed many many more using the LipiView instrument. Whether it is helpful for your rosacea is difficult to know without a proper assessment. Currently we are the only practice in Australia to have it – we are in the Sydney CBD. If you think you would like to be assessed call us on (02) 9290 1899 for an appointment.

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