Can Lipiflow Reduce Atrophy of the Meibomian Glands in MGD?
Meibomian Gland Dysfunction, also known as MGD, meibomitis, or Posterior Blepharitis, occurs when the glands of your eyelids, meibomian glands, are not functioning properly. These glands produce the oil needed for your eyes to function properly and feel comfortable. However, in MGD, these glands can become chronically obstructed. When this occurs, they can begin to atrophy and die off, meaning that they will no longer function to produce the proper oils your eyes need. For years, we have thought that this atrophy is irreversible, but recent research shows that this may not be the case.
In today's article, I will be discussing whether or not the Lipiflow procedure can reverse the atrophy we often see with the meibomian glands.
The Study and Findings
A recent retrospective, observational study has revealed that 70% of those patients treated with Lipiflow showed a reversal in their meibomian gland atrophy vs. those patients who had not undergone Lipiflow. In these patients where improvement was noted, small positive changes were seen in the glands. Researchers also found long term improvements in tear break up time, tear osmolarity, and corneal staining.
How was it measured?
The researchers looked at the visible gland structure, or the amount of atrophy present in the patients studied, both before and after their treatments with Lipiflow. The Lipiview 2 was used to visualize the glands and, in an interesting and smart twist, Photoshop was used to assess the gland details down to the pixel level. The Meibum Scale, or the gold standard scale used to assess meibomian gland structure, changes by 25% increments so could not easily be used in this study because of the precise comparisons needed.
My opinion on this study
Although a VERY low treatment population, the results are very promising. For years, we have told patients that their atrophy was irreversible. This research provides us with hope that MGD can be overcome. As I prefer to use more natural treatments for MGD, it's great to see that Lipiflow is potentially able to make these positive changes without the use of harsh medications. Because of this study, I am much more likely to prescribe Lipiflow for a patient with Meibomian Gland Dysfunction because of the positive outcomes we've seen.
Although Lipiflow can be financially and time inhibited, I believe it is a great option for those patients with MGD and especially for those with known atrophy of the glands. Patients who have previously taken Accutane come to mind, since this medication itself causes atrophy of the glands.
Have you had the Lipiflow procedure and seen great results for your dry eyes?
Let me know your successes or failures in the comments below.
Dr. Travis Zigler
SeeEO of Eye Love
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