title: [Clinical evaluation of a thermodynamic treatment system for meibomian gland dysfunction].
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of a single thermodynamic treatment system (LipiFlow) for meibomian gland dysfunction (MGD).
  
  
  METHODS
  Retrospective series case study. Forty-eight subjects with meibomian gland dysfunction were analyzed before and after 12 minutes LipiFlow system treatment. All subjects were examined before, 4 weeks and 12 weeks after this treatment. Subjective symptoms, lipid layer thickness (LLT), expressible meibomian gland, tear break-up time, meibomian gland assessment and ocular surface staining were measured. Statistical analysis was performed using SPSS 11.5 software. Analysis included those independent sample two-tailed t-tests for comparison of the mean change from baseline to 4 weeks and baseline to 12 weeks after Lipiflow treatment. Statistically significant difference was based on α=0.05 (P<0.05).
  
  
  RESULTS
  A total of 48 cases completed the 12-week follow-up. MGD patients with LipiFlow treatment had a significant reduction in the Ocular Surface Disease Index (OSDI) scores with 45.36±19.34 before treatment, 23.82±11.94 at 4 weeks (t=2.009, P=0.035) and 25.66±14.12 at 12 weeks (t=1.976 P=0.038). LipiFlow resulted in a higher number of expressible glands from 2.91±1.13 (baseline) to 6.27±2.37 (4 weeks, t=3.505, P<0.001) and 5.15±2.08 (12 weeks, t=2.004, P= 0.027) and change of secretion quality from 6.18±2.48 (baseline) to 13.55±3.46 (4 weeks,t=2.698,P=0.005) and 12.67±3.41 (12 weeks,t=2.403,P=0.009). In addition, a single thermodynamic treatment increase the LLT from (42.13±9.67)nm (baseline) to (59.02±16.39)nm (4 weeks, t=2.971, P=0.002) and (54.65±12.52)nm (12 weeks, t=2.021, P=0.021). The rate of partial blink was relieved from 0.37±0.30 (baseline) to 0.15±0.14 (4 weeks, t=3.428, P=0.035) and 0.12±0.13 (12 weeks, t=1.986, P=0.026). BUT was increased from (4.73± 2.34)s (baseline) to (9.32 ± 2.18)s (4 weeks, t=3.385, P<0.001) and (9.91 ± 3.01)s (12 weeks, t=3.253, P< 0.001). There were no unanticipated or serious device-related adverse events reported. Compared with baseline, there was no statistically significant difference in BCVA, corneal staining and intraocular pressure (P=0.141, 0.376, 0.421).
  
  
  CONCLUSIONS
  The LipiFlow system was a safety and effectiveness treatment of MGD in the 12-week study.
authors.affiliation: Beijing Institute of Ophthalmology, Beijing TongRen Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab., Beijing 100005, China; Email: lqflucky@163.com.
authors.forename: Qingfeng
authors.initials: Q
authors.lastname: Liang
authors.forename: Hanruo
authors.initials: H
authors.lastname: Liu
authors.forename: Yan
authors.initials: Y
authors.lastname: Guo
authors.forename: Rui
authors.initials: R
authors.lastname: Cui
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.forename: Ningli
authors.initials: N
authors.lastname: Wang
authors.forename: Antoine
authors.initials: A
authors.lastname: Labbe
mesh_terms: D005141:Eyelid Diseases / Q000628:therapy*; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007429:Intraocular Pressure; D008055:Lipids / Q000032:analysis; D008537:Meibomian Glands / Q000737:chemistry; D012189:Retrospective Studies; D013666:Tears; D013816:Thermodynamics; D014065:Tonometry, Ocular; D016896:Treatment Outcome
chemical_list: D008055:Lipids