title: Effect of using a combination of lid wipes, eye drops, and omega-3 supplements on meibomian gland functionality in patients with lipid deficient/evaporative dry eye.
abstract: OBJECTIVE
  The aim of this study was to assess the efficacy of using a combination treatment approach consisting of lipid emulsion eye drops, eyelid cleansing wipes, and omega-3 vitamin supplements compared with warm compresses in improving meibomian gland functionality in patients with lipid-deficient/evaporative dry eye disease (LDDE).
  
  
  METHODS
  This single-center, open-label, investigator-masked, randomized study enrolled patients aged ≥18 years, clinically diagnosed with LDDE defined as having ≤6 functional meibomian glands [meibomian gland yielding liquid secretion (MGYLS)] and positive for dry eye symptoms at screening. Patients were randomized to receive either the combination treatment (lipid emulsion eye drops, omega-3 supplements, and lid hygiene with eyelid wipes) or to apply warm, wet compresses once daily, 8 minutes per day, for 3 months. Meibomian gland functionality (number of MGYLS; primary outcome) and patient-reported subjective assessments (SPEED and OSDI questionnaires; secondary outcomes) were evaluated. Adverse events (AEs) and visual acuity were assessed as safety endpoints.
  
  
  RESULTS
  Mean patient age was 41.7 years (n = 26; n = 13 per group). Mean ± SD number of MGYLS was not statistically significantly different between groups at baseline (combination treatment, 3.5 ± 1.5; warm compresses, 4.2 ± 1.4, P > 0.5), and was significantly greater with combination treatment versus warm compresses after 3 months of treatment (9.3 ± 2.7 vs. 4.7 ± 2.3; P = 0.006). Dry eye symptoms were significantly improved in both groups at all follow-up visits. Two AEs unrelated to treatment were reported; the BCVA was unchanged from baseline in both groups.
  
  
  CONCLUSIONS
  The combination treatment regimen resulted in significant improvement in meibomian gland functionality and dry eye symptoms. No safety issues were observed.
authors: Korb Associates, Boston, MA.
authors: Donald R
authors: DR
authors: Korb
authors: Caroline A
authors: CA
authors: Blackie
authors: Victor M
authors: VM
authors: Finnemore
authors: Teresa
authors: T
authors: Douglass
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D001458:Bandages; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D015352:Dry Eye Syndromes / Q000503:physiopathology*; D005141:Eyelid Diseases / Q000503:physiopathology*; D005143:Eyelids / Q000502:physiology*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006920:Hygiene; D008055:Lipids / Q000008:administration & dosage; D065346:Lubricant Eye Drops / Q000008:administration & dosage*; D008297:Male; D008537:Meibomian Glands / Q000503:physiopathology*; D008875:Middle Aged; D011446:Prospective Studies; D013666:Tears / Q000502:physiology; D055815:Young Adult
chemical_list: D015525:Fatty Acids, Omega-3; D008055:Lipids; D065346:Lubricant Eye Drops