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Article: A Review on Evidence-Based Treatments for Meibomian Gland Dysfunction

TitleA Review on Evidence-Based Treatments for Meibomian Gland Dysfunction
Authors
KeywordsEvidence-based
Eyelid warming
Intense pulsed-light therapy
Meibomian gland dysfunction
Systematic review
Thermal pulsation
Treatment
Warm compress
Issue Date2020
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.claojournal.org/
Citation
Eye & Contact Lens, 2020, v. 46 n. 1, p. 3-16 How to Cite?
AbstractObjectives: To evaluate recent studies on available therapies for meibomian gland dysfunction (MGD). Methods: A literature search on recent publications, within the last five years, concerning treatment options for MGD was performed. Results: A total of 35 articles were reviewed after curation by the authors for relevance. In general, all modalities of treatments were shown to have clinical efficacy in alleviating dry eye signs and symptoms, although the extent of improvement and persistency of outcomes varied between the different treatments. Evidence from published studies demonstrate that thermal pulsation produces the longest lasting effect per treatment, but it also incurs the highest per-treatment cost. Reusable methods for warm compress with lipid/semi-fluorinated alkane-containing eye drops are recommended as first-line treatment for mild-to-moderate dry eye patients, because this option is most technically feasible and cost-effective in clinical practice. Intense pulsed light (IPL) therapy and thermal pulsation may be suitable as second line for patients unresponsive to warm compress therapy; however, their respective limitations need to be considered. For refractory MGD with features of periductal fibrosis or severe blepharitis, supplementary treatment with meibomian gland probing or oral antibiotics may be used. Conclusions: All eight forms of treatments, including self-applied eyelid warming, thermal pulsation, IPL, MG probing, antibiotics, lipid-containing eye drops, and perfluorohexyloctane, were effective against MGD, although with varying extent of clinical improvements. A better understanding on the mechanisms of actions may guide physicians to make better treatment decisions targeting the root causes.
Persistent Identifierhttp://hdl.handle.net/10722/279953
ISSN
2023 Impact Factor: 2.0
2023 SCImago Journal Rankings: 0.779
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLam, PY-
dc.contributor.authorShih, K-
dc.contributor.authorFong, PY-
dc.contributor.authorChan, TCY-
dc.contributor.authorNg, A-
dc.contributor.authorJhanji, V-
dc.contributor.authorTong, L-
dc.date.accessioned2019-12-23T08:24:09Z-
dc.date.available2019-12-23T08:24:09Z-
dc.date.issued2020-
dc.identifier.citationEye & Contact Lens, 2020, v. 46 n. 1, p. 3-16-
dc.identifier.issn1542-2321-
dc.identifier.urihttp://hdl.handle.net/10722/279953-
dc.description.abstractObjectives: To evaluate recent studies on available therapies for meibomian gland dysfunction (MGD). Methods: A literature search on recent publications, within the last five years, concerning treatment options for MGD was performed. Results: A total of 35 articles were reviewed after curation by the authors for relevance. In general, all modalities of treatments were shown to have clinical efficacy in alleviating dry eye signs and symptoms, although the extent of improvement and persistency of outcomes varied between the different treatments. Evidence from published studies demonstrate that thermal pulsation produces the longest lasting effect per treatment, but it also incurs the highest per-treatment cost. Reusable methods for warm compress with lipid/semi-fluorinated alkane-containing eye drops are recommended as first-line treatment for mild-to-moderate dry eye patients, because this option is most technically feasible and cost-effective in clinical practice. Intense pulsed light (IPL) therapy and thermal pulsation may be suitable as second line for patients unresponsive to warm compress therapy; however, their respective limitations need to be considered. For refractory MGD with features of periductal fibrosis or severe blepharitis, supplementary treatment with meibomian gland probing or oral antibiotics may be used. Conclusions: All eight forms of treatments, including self-applied eyelid warming, thermal pulsation, IPL, MG probing, antibiotics, lipid-containing eye drops, and perfluorohexyloctane, were effective against MGD, although with varying extent of clinical improvements. A better understanding on the mechanisms of actions may guide physicians to make better treatment decisions targeting the root causes.-
dc.languageeng-
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.claojournal.org/-
dc.relation.ispartofEye & Contact Lens-
dc.rightsThis is a non-final version of an article published in final form in Eye & Contact Lens, 2020, v. 46 n. 1, p. 3-16-
dc.subjectEvidence-based-
dc.subjectEyelid warming-
dc.subjectIntense pulsed-light therapy-
dc.subjectMeibomian gland dysfunction-
dc.subjectSystematic review-
dc.subjectThermal pulsation-
dc.subjectTreatment-
dc.subjectWarm compress-
dc.titleA Review on Evidence-Based Treatments for Meibomian Gland Dysfunction-
dc.typeArticle-
dc.identifier.emailShih, K: kcshih@hku.hk-
dc.identifier.emailNg, A: nlk008@hku.hk-
dc.identifier.authorityShih, K=rp01374-
dc.identifier.authorityNg, A=rp01842-
dc.description.naturepostprint-
dc.identifier.doi10.1097/ICL.0000000000000680-
dc.identifier.pmid31834043-
dc.identifier.scopuseid_2-s2.0-85076490444-
dc.identifier.hkuros308835-
dc.identifier.volume46-
dc.identifier.issue1-
dc.identifier.spage3-
dc.identifier.epage16-
dc.identifier.isiWOS:000525314700003-
dc.publisher.placeUnited States-
dc.identifier.issnl1542-2321-

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