TearCare MGX™ System With and Without Warming Hold (XTEND)

A Prospective, Randomized, Controlled Trial of the TearCare MGX™ System With and Without Warming Hold (Xtend)

TearCare is an office-based thermal therapeutic eyelid technology cleared by the US Food and Drug Administration for the treatment of evaporative dry eye disease due to meibomian gland dysfunction. In this randomized study, TearCare procedures using the TearCare MGX System (study device) with the extended Warming hold feature will be compared with TearCare procedures using the TearCare MGX System without the Warming hold (control group).

Study Overview

• Status: Active, not recruiting
• Conditions: Meibomian Gland Dysfunction (Disorder)
• Intervention / Treatment: Device: localized heat therapy

Detailed Description

This study will collect data to assess the clinical utility of the Warming Hold period. The TearCare MGX Warming hold is a 10-minute period beyond completion of the Core Therapy time that serves to preserve elevated temperature by outputting only enough energy to maintain heat at the lowest setting of the system. At the minimum warmth setting the SmartLid device surfaces provide a steady state temperature of 39.0°C.

This is a prospective, randomized, assessor-masked, single-center, non-significant risk (NSR) study. To reduce potential bias in the study, study staff performing the endpoint assessments will be masked. Subjects will also be masked as to group assignment.

In this randomized study, TearCare procedures using the TearCare MGX System (study device) with the extended Warming hold feature will be compared with TearCare procedures using the TearCare MGX System without the Warming hold (control group).

TearCare procedures in this study will include an in-office eyelid debridement, 15-minute bilateral thermal session with the TearCare System, immediately followed by manual expression of the meibomian glands using the Clearance Assistant Plus device. Subjects will receive one in-office TearCare procedure at the Procedure Visit.

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Ohio
    • Brecksville, Ohio, United States, 44141
      • Cleveland Eye Clinic

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Male or female subjects, 22 years of age or older
2. Reports dry eye symptoms within the past 6 months
3. OSDI score of 23 to 79
4. Meibomian gland obstruction in both eyes based on a total Meibomian Gland Secretion Score ≤12 in each eye.
5. At least 15 glands in each lower eyelid should be expressible, with a sterile cotton swab, at the slit lamp.
6. Best corrected visual acuity of 20/100 or better, OU.
7. Willing and able to comply with the study procedures and follow-up
8. Understands and signs the informed consent.

Exclusion Criteria:

1. Use of:

   1. Cyclosporine, Xiidra, or serum tears within 60 days prior to Screening;
   2. Antihistamines (oral or topical) within 7 days prior to Screening;
   3. Oral tetracyclines or azithromycin within 30 days prior to Screening;
   4. Topical ophthalmic antibiotics, anti-glaucoma medications, steroids, non-steroidal anti-inflammatory medications within 30 days prior to Screening
   5. Isotretinoin (e.g. Accutane) at any time.

2. Any of the following dry eye treatments:

   1. Office-based dry eye treatment (e.g. IPL, TearCare, thermal pulsation [LipiFlow], iLux etc.) within 12 months prior to Screening either as part of routine care or clinical investigation;
   2. Planned or recent surgical procedures to the eye or eyelid (90 days prior to Screening);
   3. Meibomian gland expression within 6 months prior to Screening;
   4. Blephex or debridement within 3 months prior to Screening;
   5. Punctal occlusion (including collagen, e.g. Soft Plug, UltraPlug, or crosslinked hyaluronic acid, e.g. Lacrifill) or punctal plugs within 15 days of the Screening visit;
   6. Use of tear neurostimulators (i.e., True Tear, iTear100, Tyrvaya) within 2 weeks of the baseline visit. (Subjects must refrain from using tear neurostimulators for the duration of the study);
   7. Any history of meibomian gland probing.
3. History of eyelid, conjunctiva, or corneal surgery (including refractive surgery) within 12 months prior to Screening.
4. Any history of chalazion surgery, surgery on the tarsal conjunctiva, radial keratotomy (RK), complicated blepharoplasty, lid reconstruction, or significant complications post-refractive surgery.
5. Contact lens use within 2 weeks of the Procedure visit. Subjects presenting at the Screening visit using contact lenses must agree to discontinue use for a full 2 weeks (14 days) prior to the Procedure visit.
6. Active hordeolum, stye, or chalazion at the time of the Screening visit.
7. History of Herpes Simplex or Herpes Zoster of the eye or eyelid.
8. Any active, clinically significant ocular or peri-ocular infection, inflammation, or irritation.
9. Recurrent clinically significant eye inflammation, other than dry eye, within 3 months prior to Screening.
10. Clinically significant anterior blepharitis. In addition, collarettes or flakes of more than one quarter of the eyelid are excluded.
11. Clinically significant eyelid abnormalities in either eye (e.g. entropion/ectropion, blepharospasm, aponeurotic ptosis, lagophthalmos, distichiasis, trichiasis).
12. Clinically significant dermatologic or cutaneous disease of the eyelid or periocular area.
13. In the clinical judgement of the Investigator, meibomian glands have significant capping, atrophy, or are unable to be expressed, digitally or with a cotton swab.
14. Corneal surface abnormalities such as corneal epithelial defects (other than punctate staining), ulcers, corneal epithelial dystrophies, keratoconus, and ectatic disease of the cornea
15. Any active, clinically significant allergic, vernal, or giant papillary conjunctivitis.
16. Ocular trauma within 3 months prior to Screening.
17. Known history of diminished or abnormal facial, periocular, ocular or corneal sensation
18. Systemic diseases, in the Investigator's medical judgement, resulting in dry eye (e.g. autoimmune diseases such as Sjogren's syndrome, rheumatoid arthritis, lupus, Graves' disease, sarcoidosis, etc.)
19. Subject is currently using Retin A /Retin A derivatives.
20. Subject has permanent eyeliner/lid tattoos, eyelash extensions or wears false eyelashes.
21. Subject is currently using Latisse, Lash Boost or any other type of eyelash growth serum. Prostaglandin analog products such as Latisse should not be used within 30 days of the Screening visit.
22. Temporary false eyelashes, lash extensions, or any other type of false eyelash within 15 days of the Screening Visit.
23. Allergies to silicone tissue adhesives, acrylates and/or copper.
24. Subject has a pacemaker or implantable cardiac defibrillators (ICD).
25. Co-existing condition, either ocular or non-ocular that, in the judgement of the Investigator could affect the safety or effectiveness of treatment or the compliance of the subject to the protocol.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: TearCare MGX with Warming Hold; 15 minute thermal treatment with TearCare MGX followed by 10 minute warming hold	Device: localized heat therapy; Blink-assisted, open eye therapy. Heat (45 degrees C) applied for 15 minutes to the upper and lower eyelids, followed by manual expression of the meibomian glands.
Active Comparator: TearCare MGX without Warming Hold; 15 minute thermal treatment with TearCare MGX without subsequent warming hold period	Device: localized heat therapy; Blink-assisted, open eye therapy. Heat (45 degrees C) applied for 15 minutes to the upper and lower eyelids, followed by manual expression of the meibomian glands.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean difference between eyes in Meibomian Gland Secretion Score (MGSS)	The Meibomian Gland Secretion Score (MGSS) grades the consistency of secretions from the meibomian glands. Fifteen meibomian glands in each of the lower eyelids were gently pressed and the secretions were scored on the scale below. Sum of the grade (0 - 3) for each of the 15 glands. Range for this score is 0-45. A higher number indicates more normal meibomian gland activity. Score Description of Secretion: 0 - Nothing; - Toothpaste; - Cloudy; - Clear The difference between eyes in the MGSS is the score for the right eye minus the score for the left eye. The mean is the arithmetic mean of this difference for all subjects.	MGSS used to calculate the difference in MGSS between eyes is obtained post-treatment at the procedure visit (Day 0).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean change from Screening visit baseline in MGSS	The Meibomian Gland Secretion Score (MGSS) grades the consistency of secretions from the meibomian glands. Fifteen meibomian glands in each of the lower eyelids were gently pressed and the secretions were scored on the scale below. Sum of the grade (0 - 3) for each of the 15 glands. Range for this score is 0-45. A higher number indicates more normal meibomian gland activity. Score Description of Secretion: 0 - Nothing 1 - Toothpaste 2 - Cloudy 3 - Clear The change from baseline in the MGSS is the score obtained following treatment at the procedure visit minus the score obtained for the same eye at the Screening visit. The mean is the arithmetic mean of this difference for all eyes.	MGSS is assessed at the Screening visit (Day -30 to Day -7) and at the Procedure visit (Day 0)
Mean change from Screening visit baseline in Meibomian Glands Yielding Any Liquid (MGYAL)	The Meibomian glands yielding any liquid (MGYAL) is the number of glands in the lower eyelid secreting any liquid, (regardless of graded quality). The score can range from 0 (no glands secreting liquid), to 15 (all 15 glands with liquid secreted). A higher score is better. The mean change from Screening visit baseline is the mean difference between the MGYAL at screening and the MGYAL post-procedure at the procedure visit.	MGYAL is assessed at the Screening visit (Day -30 to -7) and at the Procedure visit (Day 0)
Mean change from Screening visit baseline in Meibomian Glands Yielding Clear Liquid (MGYCL)	The Meibomian glands yielding clear liquid (MGYCL) is the number of glands in the lower eyelid secreting clear liquid. The score can range from 0 (no glands secreting clear liquid), to 15 (all 15 glands with clear liquid secreted). A higher score is better. The mean change from Screening visit baseline is the mean difference between the MGYCL at screening and the MGYCL post-procedure at the procedure visit.	MGYCL is assessed at the Screening visit (Day -30 to Day -7) and post-treatment at the Procedure visit (Day 0)
Subject Comfort during expression of second lid	Subject Comfort during expression of second lid is assessed following treatment using a subject completed Likert scale rating the relative comfort of eyelid gland expression for the first lid expressed versus the second.	Subject Comfort during expression of second lid is assessed post-treatment at the Procedure visit (Day 0)
Ease of expression	Ease of expression is assessed following treatment using a masked-assessor completed Likert scale rating the relative ease of eyelid gland expression for the first lid expressed versus the second.	Ease of expression is assessed following treatment at the Procedure visit (Day 0)

Collaborators and Investigators

• Sponsor: Sight Sciences, Inc.
• Investigators: Study Director: Jaime Dickerson, PhD, Sight Sciences, Inc.; Principal Investigator: Thomas Chester, OD, Cleveland Eye Clinic

Study record dates

Study Major Dates

• Study Start (Actual): March 17, 2026
• Primary Completion (Estimated): May 1, 2026
• Study Completion (Estimated): May 1, 2026

Study Registration Dates

• First Submitted: January 22, 2026
• First Submitted That Met QC Criteria: January 22, 2026
• First Posted (Actual): January 26, 2026

Study Record Updates

• Last Update Posted (Actual): April 24, 2026
• Last Update Submitted That Met QC Criteria: April 21, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Meibomian Gland Dysfunction; MGD; TearCare; XTEND
• Additional Relevant MeSH Terms: Eye Diseases; Eyelid Diseases; Meibomian Gland Dysfunction
• Other Study ID Numbers: CLN1 10280

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Protection of patient confidentiality.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: Yes
• product manufactured in and exported from the U.S.: No