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Efficacy of Plate Expression of Meibum on Tear Function and Ocular Surface Findings in Meibomian Gland Disease

Aketa, Naohiko, M.D.; Shinzawa, Megumi, M.D.; Kawashima, Motoko, M.D., Ph.D.; Dogru, Murat, M.D., Ph.D.; Okamoto, Shosei, M.D.; Tsubota, Kazuo, M.D., Ph.D.; Shimazaki, Jun, M.D., Ph.D.

doi: 10.1097/ICL.0000000000000535

Purpose: To evaluate the clinical effectiveness of expression treatment on meibomian gland disease (MGD).

Methods: Seventeen right eyes of 17 patients with MGD were divided into 3 groups in this randomized prospective clinical study: no expression group: routine treatment with no expression (five patients, five eyes); digital expression group: routine treatment with digital expression (five patients, five eyes); and plate expression group: routine treatment with plate expression (seven patients, seven eyes). All groups received the same routine treatment for 1 month. Tear film break-up time (TBUT), vital staining scores, meibum expressibility, and the dry eye–related quality of life score (DEQS) questionnaire results were assessed before and 1 month after treatment.

Results: There was a statistically significant difference of posttreatment TBUT among groups as determined by one-way analysis of variance (P<0.05). A post hoc test revealed that TBUT was statistically significantly higher in plate expression group compared with digital expression group. The fluorescein staining score did not show a statistically significant difference among the groups. Meibum expressibility and the DEQS scores improved in all groups.

Conclusion: Plate expression when used as an adjunct to routine medical management of MGD has been found to be a comparatively effective treatment in terms of improvement of tear film stability compared with no expression or digital expression.

Department of Ophthalmology (N.A., M.S., J.S.), Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Japan; Department of Ophthalmology (N.A., M.S., M.K., K.T.), Keio University School of Medicine, Tokyo, Japan; and Takasago Eye Clinic (S.O.), Takasago, Japan.

Address correspondence to Murat Dogru, M.D., Ph.D., Department of Ophthalmology, Tokyo Dental College, Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 272-8513, Japan; e-mail:

The authors have no funding or conflicts of interest to disclose.

Presented at the Japan Cornea Conference, Fukuoka, Japan, February 18, 2017.

Accepted June 04, 2018

© 2019 Contact Lens Association of Ophthalmologists, Inc.