Evaluation of an automated thermodynamic treatment (LipiFlow®) system for meibomian gland dysfunction: a prospective, randomized, observer-masked trial

Ocul Surf. 2014 Apr;12(2):146-54. doi: 10.1016/j.jtos.2013.12.001. Epub 2014 Jan 22.

Abstract

Purpose: To compare the effectiveness of a single LipiFlow(®) treatment with combined lid warming and massage in patients with meibomian gland dysfunction (MGD).

Methods: In this prospective, randomized, crossover, observer-masked clinical trial, subjects were randomized to receive either a single 12-min LipiFlow-LipiFlow Thermal Pulsation (LTP) system treatment or to perform combined twice-daily lid warming and massage for 3 months. All subjects were examined before, and 1 and 3 months after initiation of treatments. Investigated parameters included subjective symptoms, lipid layer thickness, meibomian gland assessment, tear break-up time, tear osmolarity, corneal and conjunctival staining, Schirmer test values, and tear meniscus height.

Results: A total of 31 subjects completed the 3-month follow-up. At 1 and 3 months, patients in the LipiFlow treatment group had a significant reduction in Ocular Surface Disease Index (OSDI) scores compared with those in the lid-margin hygiene group. Both treatments produced a significant improvement in expressible meibomian glands compared to the baseline parameters, but no significant difference was noted between the two groups. The other investigated objective parameters did not show a significant difference.

Conclusion: Results of our study show that a single LipiFlow treatment is as least as effective as a 3-month, twice-daily lid margin hygiene regimen for MGD. However, the present study was observer-masked only, and therefore a placebo effect may have confounded any improvements in subjective symptoms and other parameters in both groups.

Trial registration: ClinicalTrials.gov NCT01769105.

Keywords: LipiFlow(®); dry eye; meibomian gland dysfunction (MGD).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Cross-Over Studies
  • Dry Eye Syndromes / physiopathology
  • Dry Eye Syndromes / therapy*
  • Eyelid Diseases / physiopathology
  • Eyelid Diseases / therapy*
  • Eyelids / physiology
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced / methods*
  • Male
  • Massage / methods*
  • Meibomian Glands / physiopathology*
  • Middle Aged
  • Prospective Studies
  • Single-Blind Method
  • Tears / physiology
  • Treatment Outcome
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT01769105