Objectives:
To evaluate recent studies on available therapies for
meibomian gland dysfunction (MGD).
Methods:
A literature search on recent publications, within the last five years, concerning
treatment options for MGD was performed.
Results:
A total of 35 articles were reviewed after curation by the authors for relevance. In general, all modalities of treatments were shown to have clinical efficacy in alleviating dry eye signs and symptoms, although the extent of improvement and persistency of outcomes varied between the different treatments. Evidence from published studies demonstrate that
thermal pulsation produces the longest lasting effect per
treatment, but it also incurs the highest per-
treatment cost. Reusable methods for
warm compress with lipid/semi-fluorinated alkane-containing eye drops are recommended as first-line
treatment for mild-to-moderate dry eye patients, because this option is most technically feasible and cost-effective in clinical practice. Intense pulsed light (IPL) therapy and
thermal pulsation may be suitable as second line for patients unresponsive to
warm compress therapy; however, their respective limitations need to be considered. For refractory MGD with features of periductal fibrosis or severe blepharitis, supplementary
treatment with meibomian gland probing or oral antibiotics may be used.
Conclusions:
All eight forms of treatments, including self-applied
eyelid warming,
thermal pulsation, IPL, MG probing, antibiotics, lipid-containing eye drops, and perfluorohexyloctane, were effective against MGD, although with varying extent of clinical improvements. A better understanding on the mechanisms of actions may guide physicians to make better
treatment decisions targeting the root causes.
