A single, 12-minute vectored thermal pulsation procedure presents a favorable alternative to the long-term use of oral antibiotics for meibomian gland dysfunction, according to researchers.
The study included 28 subjects with moderate-to-severe meibomian gland dysfunction (MGD) who were randomized to receive either doxycycline treatment or vectored thermal pulsation (VTP) in a 1:1 ratio, or 14 patients in each treatment group.
The oral doxycycline was administered for 3 months at 100 mg twice daily for the first 14 days and 100 mg once daily for days 15 to 90. Those randomized to the VTP group received a single bilateral 12-minute VTP procedure with the LipiFlow System (TearScience).
Two subjects in the doxycycline group discontinued their treatment regimen due to stomach upset/intolerance to study medication, and one subject in the VTP group was lost to follow-up.
The mean age of subjects in the VTP group was 51.7 years and for the doxycycline group was 50.4 years.
At 3 months, the Standard Patient Evaluation for Eye Dryness (SPEED) scores, meibomian glands yielding liquid secretion (MGYLS) and tear break-up time (TBUT) were significantly improved from baseline in the VTP group. Researchers also found significant improvement in corneal fluorescein (CF) staining and conjunctival lissamine green (CLG) staining in this group.
In the doxycycline group, SPEED scores, MGYLS and CLG staining improved significantly from their pretreatment levels but the improvement in TBUT and CF staining did not reach statistical significance.
A comparison between the two groups at 3 months revealed that the mean SPEED scores of the VTP group were significantly better than the doxycycline group, according to researchers. MGYLS, TBUT, CF staining and CLG staining were found comparable between the two groups.
The outcomes of the single VTP procedure are in line with the other studies reporting a predictably significant improvement in MGD and reduction in dry eye symptoms after a single VTP treatment, the researchers wrote. Doxycycline can cause side effects that may harm patient compliance and result in discontinuing treatment.
“The VTP procedure lasts only 12 minutes, has an exceptional safety profile and has been shown to result in sustained clinically significant improvement in gland function and reduced dry eye symptoms observed over 12 to 36 months,” the researchers wrote.
VTP in combination with short-term doxycycline may be appropriate for advanced stages of MGD. The procedure may induce positive changes in the fatty acid composition of meibomian gland secretions, and VTP helps clear the obstruction, the researchers concluded. – by Abigail Sutton
Disclosure: Hagen reports no relevant financial disclosures. Please see the full study for all other authors’ disclosures.