What is better for MGD? Doxycycline or Lipiflow?
Meibomian Gland Dysfunction, also known as MGD, meibomitis, or Posterior Blepharitis, is where the glands of your eyelids, meibomian glands, are not functioning properly. Therefore the oil, or meibum, that these glands produce is not secreted onto the surface of the eye. The purpose of this meibum is to moisturize and lubricate the eye, while keeping the three layers of tears intact.
There are many ways to treat meibomian gland dysfunction naturally and at home, which I discuss in great detail in another article [Click Here to Read]. In today's article I will be discussing two in-office or prescription-required procedures, Lipiflow and oral doxycycline.
A recent study published January 17, 2018, has revealed that a single Lipiflow procedure was significantly more effective than a 3-month daily dose of oral doxycycline at improving dry eye symptoms secondary to meibomian gland dysfunction. It did state that both choices improve meibomian gland function and signs of MGD. Since Lipiflow has significantly lower side effects than doxycycline, it is the preferred treatment to improve symptoms of dry eye from MGD.
How was it measured?
The researchers measured 28 patients split into two groups. 14 received a single Lipiflow procedure and 14 received daily oral doxycycline for 3 months. Prior to any treatment and after 3-months of therapy, the participants were evaluated for the following: dry eye symptoms with a SPEED questionnaire (Standard Patient Evaluation for Eye Dryness), meibomian gland function by counting the number of glands secreting oil, tear break up time (TBUT), and corneal and conjunctival staining.
My opinion on this study
Although a VERY low treatment population (only 28 participants), the results are very promising as I prefer to use more natural treatments for MGD. Lipiflow is done without the use of any medication or antibiotics, and does not mess with the homeostasis of your body. However, doxycycline for three months is taking an antibiotic for its side effect purposes. I vowed to never prescribe an antibiotic unless absolutely necessary. Therefore I would much rather discuss Lipiflow with a patient than give them a prescription for doxycycline.
Both of these treatment options can be financially and time inhibited, which is why I always discuss natural, at-home treatments for MGD prior to discussing these. If we still aren't getting results with natural, at-home therapies, that is when I pull these out of the "dry eye tool shed."
Have you had lipiflow or taken doxycycline for your MGD or dry eyes?
Let me know your successes or failures in the comments below.
Dr. Travis Zigler
SeeEO of Eye Love
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