Steven L. Maskin
Meibomian gland probing showed efficacy in re-establishing functionality and promoting growth of new glandular tissue in patients with obstructive meibomian gland dysfunction.
Meibomian gland probing (MGP) uses sterile stainless steel wire probes to unblock the gland orifice at both ends, also removing the fixed obstruction from fibrotic tissue. Previous studies have shown that this method restores healthy meibomian gland secretions, providing immediate relief from lid tenderness.
MGP was used on the upper eyelid of 13 eyes, leading to an average 6.38% increase in total glandular area per lid.
The authors noted that heat and pressure, more commonly used to release the clotted meibum from meibomian glands, may provide short-term relief but may also, paradoxically, increase intraductal pressure and inflammation because the fixed obstruction is not removed.
“By relief of all obstructions, MGP appears to equilibrate intraductal pressure with immediate relief of lid tenderness, reduce inflammation and may create a microenvironment conducive to growth or meibomian gland tissue,” the authors wrote.
Growth of meibomian glands was observed in more than 40% of upper lids following MGP with follow-up between 4.5 and 12 months, with mean individual gland area growing up to 21% (p = 0.0277) within areas of dropout (presumed atrophy). Lengthening of shortened glands, partial restoration of faded glands and appearance of new glands was visible on noncontact infrared meibography.
The authors noted, however, that the factors that led to obstructive meibomian gland dysfunction persist after the treatment and in most cases led to redevelopment of symptoms, necessitating retreatment on an annual basis.
“MGP relieves obvious (distal) and occult (deeper or proximal) fixed unyielding and non-fixed meibomian gland obstructions and unequivocally establishes or confirms a patent meibum outflow tract through the natural orifice while providing positive physical proof as well as restores gland functionality and relieves symptoms,” study author Steven L. Maskin, MD, told Primary Care Optometry News.
“MGP may promote glandular growth, in part, by direct mechanical establishment of a patent duct/orifice system,” he continued. “We can now look at the future of treatment for obstructive meibomian gland dysfunction as not limited to symptom relief but to restore a full, functional, healthy and resilient meibomian gland lid population.” – by Michela Cimberle
Disclosure: Maskin holds patents on intraductal diagnosis and treatment of meibomian gland diseases.