title: Efficacy of Intraductal Meibomian Gland Probing on Tear Function in Patients With Obstructive Meibomian Gland Dysfunction.
abstract: OBJECTIVE
  To assess the efficacy and safety of intraductal meibomian gland probing in patients with obstructive meibomian gland dysfunction who experienced little improvement with eyelid warming, massage, or artificial tears.
  
  
  METHODS
  Forty-nine patients with obstructive meibomian gland dysfunction were randomly divided into 2 groups: intraductal meibomian gland probing with 0.1% fluorometholone (group I), and 0.1% fluorometholone alone (group II). Subjective symptom scores and objective signs, including lid margin abnormalities, meibum quality and expressibility, meibomian gland dropout, fluorescein staining, tear break-up time (TBUT), and Schirmer I test results, were recorded before treatment and after 1 day, 1 week, and 1 month posttreatment.
  
  
  RESULTS
  Clinical subjective symptoms and objective signs including meibum grade, TBUT, lid margin abnormalities, and fluorescein staining demonstrated significant improvements in both groups after treatment over time (all P < 0.05), and group I was better than group II 1 month after treatment in meibum grade (6.1 ± 3.3 vs. 10.4 ± 4.9, respectively; P < 0.001), lid margin abnormalities (0.8 ± 0.1 vs. 1.3 ± 0.3, respectively; P < 0.001), and TBUT (8.2 ± 2.1 vs. 7.0 ± 3.0, respectively; P = 0.0293). Before applying any medications, 76% of patients obtained immediate symptom relief 1 day after probing. However, the Schirmer I test results and meibomian gland dropout were insignificant pre- and posttreatment in either group (P > 0.1, respectively).
  
  
  CONCLUSIONS
  Intraductal meibomian gland probing demonstrated significant efficacy in symptom relief and tear film stabilization. Probing helped release accumulated meibum and could help increase the accessibility of diseased meibomian glands to topical corticosteroids.
authors.affiliation: Department of Ophthalmology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Ma
authors.forename: Yan
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000368:Aged; D002404:Catheterization / Q000379:methods*; D005141:Eyelid Diseases / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005469:Fluorometholone / Q000008:administration & dosage; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008537:Meibomian Glands / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D013194:Staining and Labeling; D011795:Surveys and Questionnaires; D013666:Tears / Q000502:physiology*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D005469:Fluorometholone