Focused ultrasound stimulation on meibomian glands for the treatment of evaporative dry eye

2021 ◽  
pp. 153537022110520
Author(s):  
Gengxi Lu ◽  
Sumanth Gollapudi ◽  
Runze Li ◽  
Margaret L Pfeiffer ◽  
Preeya Mehta ◽  
...  
Keyword(s):  
Layer Thickness ◽  
Dry Eye ◽  
Focused Ultrasound ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Lipid Layer ◽  
Mean Values ◽  
Ultrasound Stimulation ◽  
Evaporative Dry Eye ◽  
Meibomian Glands

Current treatments for meibomian gland dysfunction have several limitations, creating a necessity for other advanced treatment options. The purpose of this study is to determine the effectiveness of focused ultrasound stimulation for the treatment of dry eye disease caused by meibomian gland dysfunction. An in vivo study of nine Dutch Belted rabbits was conducted with focused ultrasound stimulation of the meibomian glands. A customized line-focused ultrasonic transducer was designed for treatment. Fluorescein imaging, Schirmer’s test, and Lipiview II ocular interferometer were used to quantify outcomes from three aspects: safety, tear production, and lipid layer thickness. Both tear secretion and lipid layer thickness improved following ultrasound treatment. Five to 10 min after the ultrasound treatment, the mean values of lipid layer thickness increased from 55.33 ± 11.15 nm to 95.67 ± 22.77 nm ( p < 0.05), while the mean values measured with the Schirmer’s test increased from 2.0 ± 2.3 to 7.2 ± 4.3 ( p < 0.05). Positive effects lasted more than three weeks. Adverse events such as redness, swelling, and mild burn, occurred in two rabbits in preliminary experiments when the eyelids sustained a temperature higher than 42°C. No serious adverse events were found. The results suggest that ultrasound stimulation of meibomian glands can improve both tear production and lipid secretion. Ultimately, ultrasound stimulation has the potential to be an option for the treatment of evaporative dry eye disease caused by meibomian gland dysfunction.

scholarly journals Pediatric Chalazion Case Report

2018 ◽  
Vol 1 (1) ◽  
pp. e28-e31
Author(s):  
Liem Hieu Nguyen ◽  
Edward H. Jaccoma
Keyword(s):  
Case Report ◽  
Dry Eye ◽  
Pediatric Population ◽  
Meibomian Gland ◽  
Dry Eye Disease ◽  
Meibomian Gland Dysfunction ◽  
Eye Disease ◽  
Old Patients ◽  
Evaporative Dry Eye ◽  
Meibomian Glands

Background and Objectives A chalazion, also known as a stye, is a common and chronic inflammatory problem of the eyelids where one or more Meibomian glands are blocked. Previous studies have shown that a chalazion is a sign of Meibomian Gland Dysfunction (MGD) and evaporative dry eye disease. The prevalence of chalazia in the pediatric population has recently been noted. In this report, we will describe two pediatric cases of chalazion that are associated with MGD and related dry eye disease.  Methods This is a case report of non-genetically related 7-year-old and 16-year-old patients as they were each seen for newly developed chalazia. Results External exam in both patients showed chalazia, waxy plugs and poor Meibomian gland expression. Meibography showed shorten, truncated, and dilated Meibomian glands with rapid tear break-up times leading to the diagnosis of evaporative dry eye disease due to MGD. Conclusion These cases serve to confirm an increase in the prevalence of MGD in the pediatric population and to emphasize the need for early screening for dry eye disease.  Key Words: Chalazion - Meibomian gland dysfunction - Pediatric Dry Eye Disease

scholarly journals Effects of warm compress on tear film, blink pattern and Meibomian gland function in dry eyes after corneal refractive surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xueyi Zhou ◽  
Yang Shen ◽  
Jianmin Shang ◽  
Xingtao Zhou
Keyword(s):  
Dry Eye ◽  
Corneal Thickness ◽  
Tear Film ◽  
Meibomian Gland ◽  
Blink Rate ◽  
Lipid Layer ◽  
Dry Eyes ◽  
Mean Values ◽  
Before And After ◽  
Gland Function

Abstract Background To assess the effects of warm compress (WC) on tear film lipid layer, blink pattern and Meibomian gland function in patients with dry eye following femtosecond laser small incision lenticule extraction (SMILE) and laser-assisted subepithelial keratomileusis (LASEK). Methods We enrolled 37 eyes of 37 participants, each with dry eye for more than 2 years following SMILE (25 eyes) or LASEK (12 eyes). WC was performed using a spontaneously heating eye mask. Tear film break-up time (TBUT), tear film lipid layer thickness (TFLLT), blink pattern, Meibomian secretory function scores (MGS), visual acuity, spherical equivalent (SE), keratometry, central corneal thickness (CCT) and aberration were assessed before and after WC. Results After WC, the following mean values all increased relative to baselines: CCT, SE, minimum (Min-), maximum (Max-) and average (Ave-) TFLLT, TBUT, total MGS (TMGS), number of glands secreting any liquid (MGL), and complete blink rate (CBR) (p values ranging from < 0.001 to 0.042). Partial blink frequency (PBF) and partial blink rate (PBR) decreased (p = 0.002 in both cases). The decrease of PBF was higher in SMILE subgroup than in LASEK (p = 0.030). TBUT variation was positively correlated with that of Ave-TFLLT and TMGS (p = 0.046, 0.028, respectively). Max-TFLLT variation was correlated with that of TMGS (p = 0.020). Conclusions WC may temporarily increase tear film thickness and stability, decrease partial blink, and partly augment Meibomian gland function in dry eye patients after corneal refractive surgeries. Future studies are required to investigate long term clinical efficacy and safety.

scholarly journals Analysis of tear inflammatory molecules and clinical correlations in evaporative dry eye disease caused by meibomian gland dysfunction

2020 ◽  
Vol 40 (11) ◽  
pp. 3049-3058
Author(s):  
Xingdi Wu ◽  
Xiang Chen ◽  
Yajuan Ma ◽  
Xueqi Lin ◽  
Xuewen Yu ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Healthy Subjects ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Surface Parameters ◽  
Tnf Α ◽  
Evaporative Dry Eye ◽  
Ifn Γ ◽  
Inflammatory Molecules

Abstract Purpose To compare the levels of inflammatory molecules in tear samples between patients with meibomian gland dysfunction (MGD)-related evaporative dry eye (EDE) and healthy subjects and to analyze the correlations between the levels of tear inflammatory molecules and ocular surface parameters. Methods A total of 30 MGD-related EDE patients (48 eyes) and ten healthy volunteers (15 eyes) were enrolled. Dry eye-related examinations and questionnaires were obtained from all participants. The levels of nine inflammatory molecules were determined through multiplex bead analysis. Results Inflammatory molecules including ICAM-1, IFN-γ, CXCL8/IL-8, IL-6, TNF-α and IL-12p70 were detected in 100% of the patients, while IL-1α, IL-1β and IL-10 were detected in 56.25%, 13.60% and 45.83% of the patients, respectively. Moreover, ICAM-1, IL-8, IL-6, TNF-α, IL-12p70 and IFN-γ were detected in 86.67–100% of the healthy subjects, and the detection rates of IL-10, IL-1α and IL-1β were below 50%. The levels of IL-8, IL-6, IFN-γ and ICAM-1 were significantly higher in the patient group compared with the control group. In addition, IL-8 and IL-6 were negatively correlated with Schirmer I test. Besides, IFN-γ was negatively correlated with tear film breakup time. Furthermore, ICAM-1 and IL-6 were positively correlated with meibography score. Conclusions Collectively, patients with MGD-related EDE had higher levels of inflammatory molecules in their tears, and some molecules were correlated with ocular surface parameters. These findings suggested that inflammation played an important role in MGD-related EDE, and several inflammatory molecules could be used in the diagnosis and the treatment of MGD-related EDE.

scholarly journals Effects of Warm Compress on Tear Film, Blink Pattern and Meibomian Gland Function in Dry Eyes After Corneal Refractive Surgery

2021 ◽  
Author(s):  
Xueyi Zhou ◽  
Yang Shen ◽  
Jianmin Shang ◽  
Xingtao Zhou
Keyword(s):  
Dry Eye ◽  
Refractive Surgery ◽  
Corneal Thickness ◽  
Tear Film ◽  
Meibomian Gland ◽  
Blink Rate ◽  
Lipid Layer ◽  
Mean Values ◽  
Corneal Refractive Surgery ◽  
Gland Function

Abstract Background To assess the effects of warm compress (WC) on tear film lipid layer, blink pattern and Meibomian gland function in patients with dry eye following femtosecond laser small incision lenticule extraction (SMILE) and laser-assisted subepithelial keratomileusis (LASEK). Methods We enrolled 37 eyes of 37 participants, each with dry eye for more than 2 years following SMILE (25 eyes) or LASEK (12 eyes). WC was performed using a spontaneously heating eye mask. Safety parameters and effectiveness parameters (tear film break-up time, TBUT; tear film lipid layer thickness, TFLLT; blink pattern, and Meibomian secretory function scores, MGS) were assessed before and after WC. Results After WC, the following mean values all increased relative to baselines: central corneal thickness, spherical equivalent, minimum (Min-), maximum (Max-) and average (Ave-) TFLLT, TBUT, total MGS (TMGS), number of glands secreting any liquid (MGL), and complete blink rate (CBR) (p values ranging from < 0.0001 to 0.042). Partial blink frequency (PBF) and partial blink rate (PBR) decreased (p = 0.002 in both cases). The decrease of PBF was higher in SMILE subgroup than in LASEK (p = 0.030). TBUT variation was positively correlated with that of Ave-TFLLT and TMGS (p = 0.046, 0.028, respectively). Max-TFLLT variation was correlated with that of TMGS (p = 0.020). Conclusions WC may temporarily improve tear film quality and blink pattern, augment Meibomian gland function, and relieve dry eye symptoms after corneal refractive surgery, particularly that using the SMILE technique.

scholarly journals Biofilm Theory for Lid Margin and Dry Eye Disease

2021 ◽  
Author(s):  
Maria Vincent ◽  
Jose Quintero ◽  
Henry D. Perry ◽  
James M. Rynerson
Keyword(s):  
Virulence Factors ◽  
Dry Eye ◽  
Clinical Manifestations ◽  
Disease Process ◽  
Meibomian Gland ◽  
Dry Eye Disease ◽  
Meibomian Gland Dysfunction ◽  
Eye Disease ◽  
Structure Damage ◽  
Evaporative Dry Eye

Blepharitis and dry eye disease have long been viewed as two distinct diseases with overlapping presentations and separate etiologies. Evaporative dry eye, although frequently associated with aqueous deficiency, is also considered a separate entity. We propose viewing dry eye, both evaporative and insufficiency, as the natural sequelae of chronic blepharitis induced by biofilm. We suggest describing this one chronic disease as dry eye blepharitis syndrome (DEBS). The disease process begins when normal flora bacteria colonize the lid margin beginning shortly after birth. This colonization accompanies the development of a biofilm on the lid margin. As years pass, the biofilm matures, and the increased bacterial population initiates the production of inflammatory virulence factors, such as exotoxins, cytolytic toxins, and super-antigens, which persist on the lid margin for the rest of the patient’s life. These virulence factors cause early follicular inflammation and later, meibomian gland dysfunction followed by aqueous insufficiency, and finally, after many decades, loss of the dense collagen in the tarsal plate. We proposed four stages of DEBS, which correlate with the clinical manifestations of folliculitis (anterior blepharitis), meibomitis (meibomian gland dysfunction), lacrimalitis (aqueous deficiency), and lid structure damage evidenced by increased lid laxity resulting in entropion, ectropion, and floppy eyelid syndrome.

scholarly journals Multicenter Study of Intense Pulsed Light for Patients with Refractory Aqueous-Deficient Dry Eye Accompanied by Mild Meibomian Gland Dysfunction

2020 ◽  
Vol 9 (11) ◽  
pp. 3467
Author(s):  
Reiko Arita ◽  
Shima Fukuoka ◽  
Takanori Mizoguchi ◽  
Naoyuki Morishige
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Control Group ◽  
Pulsed Light ◽  
Lipid Layer ◽  
Film Stability ◽  
Schirmer’S Test

Aqueous-deficient dry eye (ADDE) and meibomian gland dysfunction (MGD) can be refractory to therapy. Intense pulsed light (IPL) was recently introduced as an effective treatment for MGD. We here evaluated the efficacy of IPL combined with MG expression (MGX) compared with MGX alone (n = 23 and 20, respectively) for patients with refractory ADDE with mild MGD at three sites. Symptom score, visual acuity (VA), noninvasive breakup time (NIBUT) and lipid layer thickness (LLT) of the tear film, lid margin abnormalities, fluorescein BUT (FBUT), fluorescein staining, tear meniscus height (TMH), meibum grade, meiboscore, and Schirmer’s test value were assessed at baseline and 1 and 3 months after treatment. LLT, plugging, vascularity, FBUT and NIBUT were improved only in the IPL-MGX group at three months compared with baseline. All parameters with the exception of VA, meiboscore, TMH, Schirmer’s test value were also improved in the IPL-MGX group compared with the control group at three months, as was VA in patients with central corneal epitheliopathy. Although IPL-MGX does not affect aqueous layer, the induced improvement in quality and quantity of the lipid layer may increase tear film stability and ameliorate symptoms not only for evaporative dry eye but for ADDE.

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