PURPOSE: Warm-compress therapy applied to the skin of the closed eyelids has been recommended as a treatment for meibomian gland dysfunction (MGD). Previous studies have evaluated the effects of warm-compress therapy on tear-film fluorescein break-up time and tear evaporation rate. The purpose of this study was to determine if tear-film lipid layer thickness (TFLLT) was altered following 5, 15, and 30 minutes of warm, moist compress therapy. METHODS:Twenty patients with a diagnosis of dry eye associated with MGD and a baseline TFLLT of <or= 90 nm (baseline difference between experimental and control eyes <or= 25 nm) were studied. The skin of the closed eyelids of one eye of each subject was treated for a total of 30 minutes with a compress saturated with warm (40.0 +/- 2.0 degrees C) water used as a compress; and the skin of the closed eyelids of the contralateral control eye was treated for a total of 30 minutes with a compress saturated with room-temperature (24.0 degrees C +/- 1.0 degrees C) water used as a compress. The subjects' eyes were randomized into experimental and control eyes. TFLLT was measured at the following time points: 5, 15, and 30 minutes during the 30-minute treatment period, and after 5 minutes following the 30-minute treatment period. RESULTS: The mean baseline TFLLT of the experimental eye prior to treatment with a warm, moist compress was 57.8 +/- 12.9 (standard error) nm; after 5 minutes of treatment, TFLLT was 105.8 +/- 23.7 nm; after 15 minutes of treatment, 117.8 +/- 26.4 nm; after 30 minutes of treatment, 121.5 +/- 27.1 nm; and after 5 minutes following the 30-minute treatment, 96.0 +/- 21.5 nm. The mean baseline TFLLT of the control eye prior to treatment with a room temperature, moist compress was 63.0 +/- 14.1 nm; after 5 minutes of treatment, TFLLT was 63.8 +/- 14.3 nm; after 15 minutes of treatment, 62.3 +/- 13.9 nm; after 30 minutes of treatment, 64.5 +/- 14.4 nm; and after 5 minutes following the 30-minute treatment period, 58.5 +/- 13.1 nm. Using a paired-data t-test, the results demonstrated a significant increase in mean TFLLT in the experimental eye after 5 minutes (P < 0.001), 15 minutes (P < 0.001), and 30 minutes (P < 0.001) of treatment, and after 5 minutes following the 30-minute treatment period (P < 0.001) when compared to baseline TFLLT. In comparison, there was no significant increase in TFLLT of the control eye after 5 minutes (P = 0.79), 15 minutes (P = 0.77), and 30 minutes (P = 0.81) of treatment, and after 5 minutes following the 30-minute treatment period (P = 0.20) when compared to baseline TFLLT. CONCLUSIONS: Warm, moist compress therapy applied to the skin of the closed eyelids increases TFLLT for subjects with MGD by more than 80%, 5 minutes after initiating treatment and an additional 20% after 15 minutes of treatment. This study supports clinical experience and previous reports on warm, moist compress therapy as an effective treatment for meibomian gland dysfunction.
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PURPOSE: Warm-compress therapy applied to the skin of the closed eyelids has been recommended as a treatment for meibomian gland dysfunction (MGD). Previous studies have evaluated the effects of warm-compress therapy on tear-film fluorescein break-up time and tear evaporation rate. The purpose of this study was to determine if tear-film lipid layer thickness (TFLLT) was altered following 5, 15, and 30 minutes of warm, moist compress therapy. METHODS: Twenty patients with a diagnosis of dry eye associated with MGD and a baseline TFLLT of <or= 90 nm (baseline difference between experimental and control eyes <or= 25 nm) were studied. The skin of the closed eyelids of one eye of each subject was treated for a total of 30 minutes with a compress saturated with warm (40.0 +/- 2.0 degrees C) water used as a compress; and the skin of the closed eyelids of the contralateral control eye was treated for a total of 30 minutes with a compress saturated with room-temperature (24.0 degrees C +/- 1.0 degrees C) water used as a compress. The subjects' eyes were randomized into experimental and control eyes. TFLLT was measured at the following time points: 5, 15, and 30 minutes during the 30-minute treatment period, and after 5 minutes following the 30-minute treatment period. RESULTS: The mean baseline TFLLT of the experimental eye prior to treatment with a warm, moist compress was 57.8 +/- 12.9 (standard error) nm; after 5 minutes of treatment, TFLLT was 105.8 +/- 23.7 nm; after 15 minutes of treatment, 117.8 +/- 26.4 nm; after 30 minutes of treatment, 121.5 +/- 27.1 nm; and after 5 minutes following the 30-minute treatment, 96.0 +/- 21.5 nm. The mean baseline TFLLT of the control eye prior to treatment with a room temperature, moist compress was 63.0 +/- 14.1 nm; after 5 minutes of treatment, TFLLT was 63.8 +/- 14.3 nm; after 15 minutes of treatment, 62.3 +/- 13.9 nm; after 30 minutes of treatment, 64.5 +/- 14.4 nm; and after 5 minutes following the 30-minute treatment period, 58.5 +/- 13.1 nm. Using a paired-data t-test, the results demonstrated a significant increase in mean TFLLT in the experimental eye after 5 minutes (P < 0.001), 15 minutes (P < 0.001), and 30 minutes (P < 0.001) of treatment, and after 5 minutes following the 30-minute treatment period (P < 0.001) when compared to baseline TFLLT. In comparison, there was no significant increase in TFLLT of the control eye after 5 minutes (P = 0.79), 15 minutes (P = 0.77), and 30 minutes (P = 0.81) of treatment, and after 5 minutes following the 30-minute treatment period (P = 0.20) when compared to baseline TFLLT. CONCLUSIONS: Warm, moist compress therapy applied to the skin of the closed eyelids increases TFLLT for subjects with MGD by more than 80%, 5 minutes after initiating treatment and an additional 20% after 15 minutes of treatment. This study supports clinical experience and previous reports on warm, moist compress therapy as an effective treatment for meibomian gland dysfunction.
Authors: Penny A Asbell; Fiona J Stapleton; Kerstin Wickström; Esen K Akpek; Pasquale Aragona; Reza Dana; Michael A Lemp; Kelly K Nichols Journal: Invest Ophthalmol Vis Sci Date: 2011-03-30 Impact factor: 4.799
Authors: Yoshihiro Inamoto; Nuria Valdés-Sanz; Yoko Ogawa; Monica Alves; Luigi Berchicci; John Galvin; Hildegard Greinix; Gregory A Hale; Biljana Horn; Debra Kelly; Hien Liu; Scott Rowley; Helene Schoemans; Ami Shah; Maria Teresa Lupo Stanghellini; Vaibhav Agrawal; Ibrahim Ahmed; Asim Ali; Neel Bhatt; Michael Byrne; Saurabh Chhabra; Zachariah DeFilipp; Kristina Fahnehjelm; Nosha Farhadfar; Erich Horn; Catherine Lee; Sunita Nathan; Olaf Penack; Pinki Prasad; Seth Rotz; Alicia Rovó; Jean Yared; Steven Pavletic; Grzegorz W Basak; Minoo Battiwalla; Rafael Duarte; Bipin N Savani; Mary E D Flowers; Bronwen E Shaw; Igor Petriček Journal: Biol Blood Marrow Transplant Date: 2018-11-24 Impact factor: 5.742