Randomised masked clinical trial of the MGDRx EyeBag for the treatment of meibomian gland dysfunction-related evaporative dry eye

Paramdeep Singh Bilkhu, Shehzad Anjam Naroo, James Stuart Wolffsohn, Paramdeep Singh Bilkhu, Shehzad Anjam Naroo, James Stuart Wolffsohn

Abstract

Background/aims: To investigate the efficacy and safety of the MGDRx EyeBag (The Eyebag Company, Halifax, UK) eyelid warming device.

Methods: Twenty-five patients with confirmed meibomian gland dysfunction (MGD)-related evaporative dry eye were enrolled into a randomised, single masked, contralateral clinical trial. Test eyes received a heated device; control eyes a non-heated device for 5 min twice a day for 2 weeks. Efficacy (ocular symptomology, non-invasive break-up time, lipid layer thickness, osmolarity, meibomian gland dropout and function) and safety (visual acuity, corneal topography, conjunctival hyperaemia and staining) measurements were taken at baseline and follow-up. Subsequent patient device usage and ocular comfort was ascertained at 6 months.

Results: Differences between test and control eyes at baseline were not statistically significant for all measurements (p>0.05). After 2 weeks, statistically significant improvements occurred in all efficacy measurements in test eyes (p<0.05). Visual acuity and corneal topography were unaffected (p>0.05). All patients maintained higher ocular comfort after 6 months (p<0.05), although the benefit was greater in those who continued usage 1-8 times a month (p<0.001).

Conclusions: The MGDRx EyeBag is a safe and effective device for the treatment of MGD-related evaporative dry eye. Subjective benefit lasts at least 6 months, aided by occasional retreatment.

Trial registration number: NCT01870180.

Keywords: Ocular surface; Tears; Treatment other.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Figures

Figure 1
Figure 1
Mean ocular comfort scores for control eyes and test eyes during the treatment period (Day 1 to Day 14). Error bars represent 1 SD. The difference in ocular comfort scores between control and test eyes was statistically significant (p

References

    1. Geerling G, Tauber J, Baudouin C, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on management and treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci 2011;52:2050–64.
    1. Goto E, Monden Y, Takano Y, et al. Treatment of non-inflamed obstructive meibomian gland dysfunction by an infrared warm compression device. Br J Ophthalmol 2002;86:1403–7.
    1. Olson MC, Korb DR, Greiner JV. Increase in tear film lipid layer thickness following treatment with warm compresses in patients with meibomian gland dysfunction. Eye Contact Lens 2003;29:96–9.
    1. Mori A, Shimazaki J, Shimmura S, et al. Disposable eyelid-warming device for the treatment of meibomian gland dysfunction. Jpn J Ophthalmol 2003;47:578–86.
    1. Matsumoto Y, Dogru M, Goto E, et al. Efficacy of a new warm moist air device on tear functions of patients with simple meibomian gland dysfunction. Cornea 2006;25:644–50.
    1. Ishida R, Matsumoto Y, Onguchi T, et al. Tear Film with “Orgahexa EyeMasks” in Patients with Meibomian Gland Dysfunction. Optom Vis Sci 2008;85:684–91.
    1. Friedland BR, Fleming CP, Blackie CA, et al. A novel thermodynamic treatment for meibomian gland dysfunction. Curr Eye Res 2011;6:79–87.
    1. Greiner JV. A single LipiFlow Thermal Pulsation System treatment improves meibomian gland function and reduces dry eye symptoms for 9 months. Curr Eye Res 2012;37:272–8.
    1. 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.
    1. Greiner JV. Long-term (12-month) improvement in meibomian gland function and reduced dry eye symptoms with a single thermal pulsation treatment. Clin Exp Ophthalmol 2013;41:524–30.
    1. Blackie CA, Solomon JD, Greiner JV, et al. Inner eyelid surface temperature as a function of warm compress methodology. Optom Vis Sci 2008;85:675–83.
    1. Bilkhu PS, Naroo SA, Wolffsohn JS. Effect of a commercially available warm compress on eyelid temperature and tear film in healthy eyes. Optom Vis Sci 2014;91:163–70.
    1. Tomlinson A, Bron AJ, Korb DR, et al. The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee. Invest Ophthalmol Vis Sci 2011;52:2006–49.
    1. Tomlinson A, McCann LC, Pearce EI. Comparison of human tear film osmolarity measured by electrical impedance and freezing point depression techniques. Cornea 2010;29:1036–41.
    1. Guillon JP. Non-invasive tearscope plus routine for contact lens fitting. Contact Lens Ant Eye 1998;21:31–40.
    1. Wolffsohn JS, Purslow C. Clinical monitoring of ocular physiology using digital image analysis. Contact Lens Ant Eye 2003;26:27–35.
    1. Bron AJ, Evans VE, Smith JA. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea 2003;22:640–50.
    1. Mathers WD, Shields WJ, Sachdev MS, et al. Meibomian gland dysfunction in chronic blepharitis. Cornea 1991;10:277–85.
    1. Knop E, Knop N, Millar T, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. Invest Ophthalmol Vis Sci 2011;52:1938–78.
    1. Foulks GN. The correlation between the tear film lipid layer and dry eye disease. Surv Ophthalmol 2007;52:369–74.
    1. Isreb MA, Greiner JV, Korb DR, et al. Correlation of lipid layer thickness measurements with fluorescein tear film break-up time and Schirmer's test. Eye 2003;17:79–83.
    1. Mathers W. Evaporation from the ocular surface. Exp Eye Res 2004;78:389–94.
    1. Purslow C. Evaluation of the ocular tolerance of a novel eyelid-warming device used for meibomian gland dysfunction. Contact Lens Ant Eye 2013;36:226–31.
    1. McMonnies CW, Korb DR, Blackie CA. The role of heat in rubbing and massage-related corneal deformation. Contact Lens Ant Eye 2012;35:148–54.
    1. Solomon JD, Case CL, Greiner JV, et al. Warm compress induced visual degradation and Fischer-Schweitzer polygonal reflex. Optom Vis Sci 2007;84:580–7.

Source: PubMed

3
Abonnieren