title: Microwave decontamination of eyelid warming devices for the treatment of meibomian gland dysfunction.
abstract: OBJECTIVE
  The role of bacteria in meibomian gland dysfunction is unclear, yet contamination of compresses used as treatment may exacerbate this condition. This study therefore determined the effect of heating on bacteria on two forms of compress.
  
  
  METHODS
  Cotton flannels and MGDRx EyeBags (eyebags) were inoculated by adding experimental inoculum (Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa; one species for each set of 3 eyebags and flannels). One of each were then randomised in to 3 groups: no heating (control); therapeutic (47.4±0.7°C); or sanitisation (68±1.1°C). After treatment, bacteria cell numbers were calculated. The experiment was repeated in triplicate.
  
  
  RESULTS
  There was a statistically significant difference between each treatment with the eyebag for S. aureus (control=7.15±0.11logC/ml, therapeutic heating=5.24±0.59logC/ml, sanitisation heating=3.48±1.43logC/ml; P<0.001) and S. pyogenes (7.36±0.13, 5.73±0.26, 4.75±0.54; P<0.001). P. aeruginosa also showed a significant reduction (P<0.001) from control (6.39±0.34) to therapeutic (0.33±0.26) and sanitisation (0.33±0.21), but the latter were similar (P=1.000). For the flannels, there was significant difference between each treatment for S. aureus (6.89±0.46, 3.96±1.76, 0.42±0.90; P<0.001). For S. pyogenes, there was a significant reduction (P<0.001) from control (7.51±0.10) to therapeutic (5.91±0.62) and sanitisation (5.18±0.8), but the latter were similar (P=0.07). For P. aeruginosa, there was a significant difference (P<0.001) from control (7.15±0.36) to sanitisation (5.83±0.44); but not to therapeutic (6.84±0.31) temperatures (P=0.07).
  
  
  CONCLUSIONS
  Therapeutic heating produces a significant reduction in bacteria on the eyebags, but only sanitisation heating appears effective for flannels. However, patients should be advised to heat the eyebag to sanitisation temperatures on initial use.
authors.affiliation: Ophthalmic Research Group, School of Life and Health Sciences, Aston University Birmingham, B4 7ET, United Kingdom.
authors.forename: Paramdeep
authors.initials: P
authors.lastname: Bilkhu
authors.affiliation: Ophthalmic Research Group, School of Life and Health Sciences, Aston University Birmingham, B4 7ET, United Kingdom. Electronic address: j.s.w.wolffsohn@aston.ac.uk.
authors.forename: James S
authors.initials: JS
authors.lastname: Wolffsohn
authors.affiliation: Aston Research Centre for Healthy Aging, School of Life & Health Sciences, Aston University, Birmingham B4 7ET, United Kingdom.
authors.forename: Anthony
authors.initials: A
authors.lastname: Hilton
authors.affiliation: Aston Research Centre for Healthy Aging, School of Life & Health Sciences, Aston University, Birmingham B4 7ET, United Kingdom.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Matthews
authors.affiliation: Aston Research Centre for Healthy Aging, School of Life & Health Sciences, Aston University, Birmingham B4 7ET, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Legood
authors.affiliation: Aston Research Centre for Healthy Aging, School of Life & Health Sciences, Aston University, Birmingham B4 7ET, United Kingdom.
authors.forename: Liam
authors.initials: L
authors.lastname: Riley
mesh_terms: D018407:Bacterial Physiological Phenomena / Q000528:radiation effects*; D001458:Bandages / Q000382:microbiology*; D002470:Cell Survival / Q000528:radiation effects; D003666:Decontamination / Q000379:methods*; D004866:Equipment Contamination / Q000517:prevention & control*; D005141:Eyelid Diseases / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation*; D008537:Meibomian Glands / Q000382:microbiology; D008872:Microwaves
keywords: Bacteria; Decontamination; Eyebag; Meibomian gland dysfunction; Microwave; Warm compress