Comparison of an Automated Thermodynamic Treatment System (LipiFlow) and Warm Compresses for the Treatment of Moderate Severity of Meibomian Gland Dysfunction

• Main Authors: Wipawee Booranapong, Pinnita Prabhasawat, Suksri Chotikavanich, Sasima Tongsai, Patsathorn Naranunn, Wilaipun Thaweerattanasilp, Panida Kosrirukvongs
• Format: Article
• Language: English
• Published: Mahidol University 2019-12-01
• Series: Siriraj Medical Journal
• Subjects: Meibomian gland dysfunction; warm compresses; automated thermodynamic treatment system; LipiFlow®
• Online Access: https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/228936

Objective: To compare the efficacies of a single thermodynamic treatment system (LipiFlow®) and warm compresses used for 3 months in patients with a moderate severity of meibomian gland dysfunction (MGD).     Methods: This prospective, randomized, controlled clinical study enrolled 28 patients (22 females, 6 males; mean age, 53.9 ± 14.8 years) diagnosed as having moderate MGD by plugging at the meibomian gland orifices between one-third and two-thirds of lid margins and at least one of the following: a Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire score of 6-12;  a lipid layer thickness (LLT) score of 40-70 Interferometric Color Units; upper eyelid meiboscore of 1-2; and 3-6 expressible meibomian glands (EMGs) in the lower eyelid. Both eyes of each patient were randomized into study and control eyes. Study eyes were treated with a single, 12-minute LipiFlow® system, while control eyes received 5-minute warm compresses twice daily for 3 months. The dry eye symptoms, the number of EMGs, and LLTs were evaluated. Results: There were no significant differences in the dry eye symptoms, number of EMGs, and LLTs for both groups at baseline and at each follow-up. However, the total SPEED scores for the LipiFlow® group reduced significantly from baseline at each follow-up until 6 months. As to the warm compress group, the total SPEED scores reduced significantly from baseline at each follow-up until 3 months. Conclusion: The single LipiFlow® treatment and twice-daily warm compresses relieved the dry eye symptoms of patients with a moderate severity of MGD compared with their baseline symptoms, despite no statistical differences in the dry eye symptoms, number of EMGs, and LLTs of both treatments.