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

Wipawee Booranapong; Pinnita Prabhasawat; Suksri Chotikavanich; Sasima Tongsai; Patsathorn Naranunn; Wilaipun Thaweerattanasilp; Panida Kosrirukvongs

doi:10.33192/Smj.2020.11

Authors

Wipawee Booranapong Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-8812-0319
Pinnita Prabhasawat Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-3801-6978
Suksri Chotikavanich Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-5973-643X
Sasima Tongsai Clinical Epidemiology Unit, Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok http://orcid.org/0000-0002-2310-8888
Patsathorn Naranunn Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-0651-0330
Wilaipun Thaweerattanasilp Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-5949-547X
Panida Kosrirukvongs Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0003-0602-4786

DOI:

https://doi.org/10.33192/Smj.2020.11

Keywords:

Meibomian gland dysfunction; warm compresses; automated thermodynamic treatment system; LipiFlow®

Abstract

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.

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