title: Efficacy of topical N-acetylcysteine in the treatment of meibomian gland dysfunction.
abstract: OBJECTIVE
  To evaluate the efficacy of topical N-acetyl-cysteine (NAC) therapy in patients with meibomian gland dysfunction (MGD).
  
  
  METHODS
  Twenty patients with MGD were prospectively randomized and assigned into 2 groups. The patients were instructed to use either NAC 5% or preservative-free artificial tear topically 4 times a day for a month. All patients were instructed to apply lid hygiene once daily. Preservative-free artificial tears treated group served as control. Paired sample Student's t-tests were used to detect differences between the baseline and 1 month after treatment initiation in mean ocular symptoms, fluorescein break-up time (FBUT) values, and Schirmer scores in each group. Difference in mean ocular symptoms, Schirmer's test scores, and FBUT values between the baseline and 1 month after treatment initiation were compared between the groups using Mann-Whitney U test.
  
  
  RESULTS
  One month of topical NAC therapy provided statistically significant improvements in FBUT and Schirmer scores as compared with the initial study visit. The average Schirmer increase rate was significantly better in the NAC group than in the control group. Significant improvements for the symptoms of ocular burning, foreign body sensation, and intermittent filmy or blurred vision were noted in both groups; and only NAC-treated group showed improvement for the symptom of itching, at 1 month as compared with 1 day. NAC provided significantly better improvement in itching symptom when compared with controls.
  
  
  CONCLUSIONS
  Topical administration of NAC is thought to be effective and well tolerated in patients with MGD.
authors.affiliation: Department of Ophthalmology, Atatürk University Faculty of Medicine, Erzurum, Turkey. ilkakyol@atauni.edu.tr
authors.forename: Ilknur
authors.initials: I
authors.lastname: Akyol-Salman
authors.forename: Sedat
authors.initials: S
authors.lastname: Azizi
authors.forename: Uğur
authors.initials: U
authors.lastname: Mumcu
authors.forename: Orhan
authors.initials: O
authors.lastname: Baykal
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage* / Q000627:therapeutic use; D000287:Administration, Topical; D000328:Adult; D005141:Eyelid Diseases / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008537:Meibomian Glands; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009883:Ophthalmic Solutions; D000111:Acetylcysteine