title: Long-Term (3 Year) Effects of a Single Thermal Pulsation System Treatment on Meibomian Gland Function and Dry Eye Symptoms.
abstract: OBJECTIVE
  The present study examined the long-term (3 years) effects of a single (12 min) thermal pulsation system (TPS) treatment on symptomatic patients with evaporative dry eye disease (DED) secondary to meibomian gland dysfunction (MGD).
  
  
  METHODS
  In this prospective, cohort, observational, single-center study design, signs (meibomian gland secretion [MGS] scores and tear film breakup time [TBUT]) and symptoms (Ocular Surface Disease Index [OSDI] and Standard Patient Evaluation of Eye Dryness [SPEED] questionnaires) were determined in 20 patients (40 eyes) with MGD and dry eye symptoms at baseline (BL), 1 month, and 3 years post-TPS treatment using LipiFlow.
  
  
  RESULTS
  Meibomian gland secretion scores increased from BL (4.5±0.8) to 1 month (12.0±1.1, P≤0.001). Improvement persisted at 3 years (18.4±1.4) relative to BL (P≤0.001). Meibomian gland secretion scores in all regions of the lower eyelid were improved over BL at 1 month (nasal [P≤0.001], central [P≤0.001], temporal [P≤0.01]) and 3 years (nasal [P≤0.001], central [P≤0.001], temporal [P≤0.001]). TBUT increased from BL (4.1±0.4) to 1 month (7.9±1.4, P≤0.05) but was not significantly different than BL at 3 years (4.5±0.6, P>0.05). The OSDI scores decreased from BL (26.0±4.6) to 1 month (14.7±4.3, P≤0.001) but returned to BL levels at 3 years (22.5±5.4, P>0.05). The SPEED scores decreased from BL (13.4±1.0) to 1 month (6.5±1.3, P≤0.001), and this improvement persisted at 3 years (9.5±1.6, P≤0.001).
  
  
  CONCLUSIONS
  Thermal pulsation may be a uniquely efficacious treatment option for DED secondary to MGD in that a single 12-min procedure is associated with significant improvement in MGS and SPEED scores for up to 3 years.
authors.affiliation: Schepens Eye Research Institute, The Massachusetts Eye and Ear Infirmary and the Department of Ophthalmology, Harvard Medical School, Boston, MA; and Boston Ocular Surface Center, Boston and Winchester, MA.
authors.forename: Jack V
authors.initials: JV
authors.lastname: Greiner
mesh_terms: D000328:Adult; D000368:Aged; D015352:Dry Eye Syndromes / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D005141:Eyelid Diseases / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D008537:Meibomian Glands / Q000378:metabolism; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D013666:Tears / Q000378:metabolism; D014792:Visual Acuity