title: Mechanical meibomian gland squeezing combined with eyelid scrubs and warm compresses for the treatment of meibomian gland dysfunction.
abstract: BACKGROUND
  The aim was to investigate the efficacy of mechanical meibomian gland squeezing combined with eyelid scrubs and warm compresses in participants with moderate and severe meibomian gland dysfunction (MGD).
  
  
  METHODS
  In this prospective, uncontrolled, open label, intervention study, 32 eyes of 32 participants with moderate and severe MGD were treated with mechanical squeezing of meibomian glands in combination with eyelid scrubs and warm compresses. We evaluated tear film break-up time (TBUT), corneal and conjunctival fluorescein staining scores, biomicroscopic examination of lid margins and meibomian glands, Ocular Surface Disease Index (OSDI) questionnaire and tear film lipid layer thickness determined via an interferometer before initiating treatment and after one month of treatment.
  
  
  RESULTS
  There were significant improvements in TBUT, corneal and conjunctival fluorescein staining scores, lid margin abnormality, meibum quality and expressibility, OSDI and MGD stage after mechanical meibomian gland squeezing combined with eyelid scrubs and warm compresses (p < 0.001 for TBUT, corneal fluorescein staining scores, Dry Eye Workshop score, Oxford staining score, lid margin abnormality, meibum quality, expressibility, OSDI and MGD stage and p = 0.001 for conjunctival fluorescein staining scores). There were no significant differences in lipid layer thickness or interferometer-derived parameters before treatment and after one month of treatment. Palpebral conjunctival erosion detected after the squeezing treatment resolved spontaneously in all participants.
  
  
  CONCLUSIONS
  Mechanical squeezing of meibomian glands combined with eyelid scrubs and warm compresses can provide clinical benefits without serious adverse events.
authors.affiliation: Department of Ophthalmology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea.|The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Hun
authors.initials: H
authors.lastname: Lee
authors.affiliation: Hankuk Academy of Foreign Studies, Yongin, South Korea.
authors.forename: Minseo
authors.initials: M
authors.lastname: Kim
authors.affiliation: The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Si Yoon
authors.initials: SY
authors.lastname: Park
authors.affiliation: The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.|Corneal Dystrophy Research Institute, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Eung Kweon
authors.initials: EK
authors.lastname: Kim
authors.affiliation: The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Kyoung Yul
authors.initials: KY
authors.lastname: Seo
authors.affiliation: The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Tae-Im
authors.initials: TI
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000503:physiopathology; D003315:Cornea / Q000503:physiopathology; D015352:Dry Eye Syndromes / Q000503:physiopathology / Q000628:therapy*; D005141:Eyelid Diseases / Q000503:physiopathology / Q000628:therapy*; D005143:Eyelids / Q000503:physiopathology; D005260:Female; D015590:Fluorophotometry; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007368:Interferometry; D008027:Light; D008297:Male; D008405:Massage; D055595:Mechanical Phenomena; D008537:Meibomian Glands / Q000503:physiopathology*; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013666:Tears / Q000737:chemistry
keywords: interferometer; mechanical meibomian gland squeezing; meibomian gland dysfunction; meibomian gland squeezing forceps; tear film lipid layer thickness