title: Analysis of Meibum Before and After Intraductal Meibomian Gland Probing in Eyes With Obstructive Meibomian Gland Dysfunction.
abstract: OBJECTIVE
  To evaluate whether the amount of meibum and its viscosity change after intraductal meibomian gland probing in patients with refractory obstructive meibomian gland dysfunction (o-MGD).
  
  
  METHODS
  Six lid margins of 3 patients with refractory o-MGD underwent intraductal meibomian gland probing. Meibum and the clinical outcome were evaluated before the procedure and at a 1-month postoperative visit. Meibum was quantified with a Meibometer, and its viscosity (Shimazaki grade) was assessed simultaneously. The tear film condition was evaluated by lipid layer interferometry (DR1, Kowa, Nagoya, Japan), and meibomian gland loss was analyzed by noncontact infrared meibography. Lid margin findings, tear break-up time, fluorescein score, and ocular symptoms were also assessed.
  
  
  RESULTS
  At the postoperative visits, all cases showed improvements in meibum lipid levels (446-1376, 757-802, and 396-571 meibometer units) and meibum viscosity (grade 3-0, 3-1, and 3-2). Two cases showed an improvement in tear break-up time (2-5 and 0-6 seconds). No morphological changes in the meibomian gland were observed in any cases.
  
  
  CONCLUSIONS
  Intraductal meibomian gland probing seems to improve meibomian gland lipid levels, and it may be a good treatment option for cases of o-MGD that are resistant to conventional treatment.
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Nakayama
authors.forename: Motoko
authors.initials: M
authors.lastname: Kawashima
authors.forename: Minako
authors.initials: M
authors.lastname: Kaido
authors.forename: Reiko
authors.initials: R
authors.lastname: Arita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
mesh_terms: D000328:Adult; D000368:Aged; D005141:Eyelid Diseases / Q000378:metabolism / Q000601:surgery*; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D008537:Meibomian Glands / Q000378:metabolism / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D011446:Prospective Studies; D012629:Sebum / Q000378:metabolism*; D013666:Tears / Q000502:physiology; D014783:Viscosity