J Korean Ophthalmol Soc.  2016 May;57(5):724-733. 10.3341/jkos.2016.57.5.724.

Effects and Prognostic Factors of Automated Thermodynamic System Treatment for Meibomian Gland Dysfunction

• Nam SW
• Lim DH
• Hyun J
• Chung TY

• KMID: 2212714
• DOI: http://doi.org/10.3341/jkos.2016.57.5.724

Abstract

PURPOSE
To evaluate the effect and prognostic factors of automated thermodynamic treatment (thermal compression therapy device [KCL 1100®]) for Meibomian gland dysfunction (MGD).
METHODS
Patients (48 eyes of 24 subjects) with MGD were recruited for a prospective clinical trial. Patients received 15-minute treatments twice a day using the KCL 1100®. Severity of dry eye symptoms were evaluated using the Standard Patient Evaluation for Eye Dryness (SPEED) and Ocular Surface Disease Index (OSDI), and severity of Meibomian gland function was evaluated using the Meibomian gland expressibility (MGE), Meibomian gland secretion (MGS) score and lipid layer thickness measured by LipiView®. To evaluate ocular surface, we measured tear break-up time (BUT) and fluorescein corneal staining score (Oxford scale). Data were presented for baseline and at 2 weeks and 1 month post-treatment.
RESULTS
Dry eye symptom (SPEED, OSDI), Meibomian gland function (MGE, MGS), and ocular surface index (BUT, Oxford scale) of patients were significantly improved from baseline to 2 weeks (p < 0.05) and 1 month post-treatment (p < 0.05). In addition, patients with more severe dry eye symptom and Meibomian gland index at baseline examination achieved improvement in mild to moderate MGD (p < 0.05). Improvement of Meibomian gland function (MGE) was associated with improvement of ocular surface index (BUT, Oxford scale) (p < 0.05), but not with improvement of dry eye symptom (SPEED, OSDI) (p > 0.05). There were no significant adverse events during the treatment.
CONCLUSIONS
KCL 1100® automated thermodynamic treatment is an effective and safe treatment for MGD. Additionally, KCL 1100® is more effective in patients with moderate dry eye symptom and MGD.

Keyword

Dry eye; KCL 1100®; Meibomian gland dysfunction; Thermodynamic treatment

MeSH Terms

Fluorescein
Humans
Meibomian Glands*
Prospective Studies
Tears
Thermodynamics*
Fluorescein

Figure

• 

  Figure 1. Photographs of the thermal compression therapy device (KCL 1100®, Korea KCL, Bucheon, Korea). (A) The KCL 1100® is an automated thermodynamic treatment device system that generates heat and vibration, and massages the eyelid to treat Meibomian gland dysfunction (MGD). (B) Before the therapy, patients wore a moisturized cotton eye patch and then the device was used.

• 

  Figure 2. Improvement of dry eye symptom, ocular surface and Meibomian gland index. (A) The mean Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index (OSDI) at baseline, 2 weeks, and 1 month. (B) The mean tear break-up time (BUT) and fluorescein corneal stain score (Oxford scale) measured at baseline, 2 weeks and 1 month. (C) The mean Meibomian gland expressibility (MGE) and Meibomian gland secretion (MGS) score for the 15 Meibomian test glands of the lower eyelid and lipid layer thickness (LLT) using LipiView® (TearScience®, Morrisville, NC, USA) measured at baseline, 2 weeks and 1 month. Dry eye symptom (SPEED, OSDI), ocular surface index (BUT, Oxford scale), and Meibomian gland index (MGE, MGS) were significantly improved after 1 month of treatment with KCL 1100® (Korea KCL, Bucheon, Korea). ‘Significant (p < 0.05).

• 

  Figure 3. Relationship between pre-treatment index and improvement during 1 month of thermodynamic treatment. (A, B) Scatter plots showed a negative correlation between initial value and change in dry eye symptom (Standard Patient Evaluation of Eye Dryness [SPEED], Ocular Surface Disease Index [OSDI]) and (C, D) Meibomian gland index (lipid layer thickness [LLT], Meibomian gland expressibility [MGE]). The patients with more severe dry eye symptom (SPEED, OSDI) and Meibomian gland index (LLT, MGE) at baseline examination achieved improvement with thermal compression therapy in mild to moderate Meibomian gland dysfunction (MGD).

• 

  Figure 4. Relationship between change of Meibomian gland opening and ocular surface index, and change in Meibomian gland opening and dry eye symptom. (A, B) Scatter plots showed a correlation between change in Meibomian gland opening (Meibomian gland expressibility [MGE]) and change in ocular surface index (tear breakup time (BUT), Oxford scale). (C, D) However, dry eye symptom (Standard Patient Evaluation of Eye Dryness [SPEED], Ocular Surface Disease Index [OSDI]) was not correlated with Meibomian gland opening (MGE). Meibomian gland opening (MGE) was associated with ocular surface index (BUT, Oxford scale), but not with dry eye symptom (SPEED, OSDI).

Reference

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