Longitudinal Changes in Tear Evaporation Rates After Eyelid Warming Therapies in Meibomian Gland Dysfunction.
OBJECTIVE
Lid warming is the major treatment for meibomian gland dysfunction (MGD). The purpose of the study was to determine the longitudinal changes of tear evaporation after lid warming in patients with MGD.


METHODS
Ninety patients with MGD were enrolled from a dry eye clinic at Singapore National Eye Center in an interventional trial. Participants were treated with hot towel (n = 22), EyeGiene (n = 22), or Blephasteam (n = 22) twice daily or a single 12-minute session of Lipiflow (n = 24). Ocular surface infrared thermography was performed at baseline and 4 and 12 weeks after the treatment, and image features were extracted from the captured images.


RESULTS
The baseline of conjunctival tear evaporation (TE) rate (n = 90) was 66.1 ± 21.1 W/min. The rates were not significantly different between sexes, ages, symptom severities, tear breakup times, Schirmer test, corneal fluorescein staining, or treatment groups. Using a general linear model (repeat measures), the conjunctival TE rate was reduced with time after treatment. A higher baseline evaporation rate (≥ 66 W/min) was associated with greater reduction of evaporation rate after treatment. Seven of 10 thermography features at baseline were predictive of reduction in irritative symptoms after treatment.


CONCLUSIONS
Conjunctival TE rates can be effectively reduced by lid warming treatment in some MGD patients. Individual baseline thermography image features can be predictive of the response to lid warming therapy. For patients that do not have excessive TE, additional therapy, for example, anti-inflammatory therapy, may be required.
Singapore Eye Research Institute, Ocular Surface Research Group, Singapore.
Sharon
S
Yeo
Ngee Ann Polytechnic, School of Engineering/ Biomedical Engineering Centre, Singapore.
Jen Hong
JH
Tan
Ngee Ann Polytechnic, School of Engineering/ Biomedical Engineering Centre, Singapore.
U Rajendra
UR
Acharya
Ngee Ann Polytechnic, School of Engineering/ Biomedical Engineering Centre, Singapore.
Vidya K
VK
Sudarshan
Singapore Eye Research Institute, Ocular Surface Research Group, Singapore 3Singapore National Eye Center, Cornea and External Eye Disease Department, Singapore 4Duke-National University of Singapore Gradate Medical School, Singapore 5Yong Loo Lin School.
Louis
L
Tong
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005141:Eyelid Diseases / Q000628:therapy*; D005260:Female; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008537:Meibomian Glands; D008875:Middle Aged; D013666:Tears / Q000378:metabolism*; D013817:Thermography; D055815:Young Adult