Effect of using a combination of lid wipes, eye drops, and omega-3 supplements on meibomian gland functionality in patients with lipid deficient/evaporative dry eye

• Published in: Cornea Vol. 34; no. 4; p. 407
• Main Authors: Korb, Donald R, Blackie, Caroline A, Finnemore, Victor M, Douglass, Teresa
• Format: Journal Article
• Language: English
• Published: United States 01.04.2015
• Subjects: Administration, Oral; Adolescent; Adult; Aged; Bandages; Combined Modality Therapy; Double-Blind Method; Dry Eye Syndromes - physiopathology; Eyelid Diseases - physiopathology; Eyelids - physiology; Fatty Acids, Omega-3 - administration & dosage; Female; Humans; Hygiene; Lipids - administration & dosage; Lubricant Eye Drops - administration & dosage; Male; Meibomian Glands - physiopathology; Middle Aged; Prospective Studies; Tears - physiology; Young Adult
• ISSN: 1536-4798
• DOI: 10.1097/ICO.0000000000000366

The aim of this study was to assess the efficacy of using a combination treatment approach consisting of lipid emulsion eye drops, eyelid cleansing wipes, and omega-3 vitamin supplements compared with warm compresses in improving meibomian gland functionality in patients with lipid-deficient/evaporative dry eye disease (LDDE). This single-center, open-label, investigator-masked, randomized study enrolled patients aged ≥18 years, clinically diagnosed with LDDE defined as having ≤6 functional meibomian glands [meibomian gland yielding liquid secretion (MGYLS)] and positive for dry eye symptoms at screening. Patients were randomized to receive either the combination treatment (lipid emulsion eye drops, omega-3 supplements, and lid hygiene with eyelid wipes) or to apply warm, wet compresses once daily, 8 minutes per day, for 3 months. Meibomian gland functionality (number of MGYLS; primary outcome) and patient-reported subjective assessments (SPEED and OSDI questionnaires; secondary outcomes) were evaluated. Adverse events (AEs) and visual acuity were assessed as safety endpoints. Mean patient age was 41.7 years (n = 26; n = 13 per group). Mean ± SD number of MGYLS was not statistically significantly different between groups at baseline (combination treatment, 3.5 ± 1.5; warm compresses, 4.2 ± 1.4, P > 0.5), and was significantly greater with combination treatment versus warm compresses after 3 months of treatment (9.3 ± 2.7 vs. 4.7 ± 2.3; P = 0.006). Dry eye symptoms were significantly improved in both groups at all follow-up visits. Two AEs unrelated to treatment were reported; the BCVA was unchanged from baseline in both groups. The combination treatment regimen resulted in significant improvement in meibomian gland functionality and dry eye symptoms. No safety issues were observed.