Definition & Classification of MGD

The international workshop on Meibomian Gland Dysfunction:
Report of the definition and Classification Subcommittee.

Invest Ophthalmol Vis Sci. 2011 Mar 30;52(4):1930-37.
J. Daniel Nelson,  Jun Shimazaki,  Jose M. Benitez-del-Castillo,  Jennifer P. Craig,  James P. McCulley,  Seika Den, and Gary N. Foulks 

Summary: 

Recommended definition of MGD: Meibomian gland dysfunction (MGD) is a chronic, diffuse abnormality of the meibomian glands, commonly characterized by terminal duct obstruction and/or qualitative/quantitative changes in the glandular secretion. This may result in alteration of the tear film, symptoms of eye irritation, clinically apparent inflammation, and ocular surface disease.

Management and Treatment of Meibomian Gland Dysfunction

The International Workshop on Meibomian Gland Dysfunction:
Report of the Subcommittee on Management and Treatment of Meibomian Gland Dysfunction

Invest Ophthalmol Vis Sci. 2011 Mar 30;52(4):1922-29
Gerd Geerling, Joseph Tauber,  Christophe Baudouin,  Eiki Goto,  Yukihiro Matsumoto,  Terrence O'Brien,  Maurizio Rolando,  Kazuo Tsubota,  and Kelly K. Nichols 

Summary:

The goals of the subcommittee were to review the current practice and published evidence of medical and surgical treatment options for meibomian gland dysfunction (MGD) and to identify areas with conflicting, or lack of, evidence, observations, concepts, or even mechanisms where further research is required.

Comparing traditional compresses to Blephasteam

A comparison of an eyelid-warming device to traditional compress therapy.

A comparison of an eyelid-warming device to traditional compress therapy. Optom Vis Sci. 2012 Jul;89(7):E1035-41

Pult H , Riede-Pult BH, Purslow C.

Summary:

The Blephasteam eyelid-warming device appeared to provide more effective warming than warm and moist compresses in a group of healthy volunteers. Visual acuity, limbal redness, and eyelid redness were improved after Blephasteam use but not after treatment with compresses.

Confocal Study in MGD patients unresponsive to compress treatment

Evaluation of a novel eyelid-warming device in meibomian gland dysfunction unresponsive to traditional warm compress treatment: an in vivo confocal study

Int Ophthalmol DOI 10.1007/s10792-014-9947-3

Edoardo Villani • Elena Garoli • Veronica Canton • Francesco Pichi • Paolo Nucci • Roberto Ratiglia

Summary:

In conclusion, eyelid warming is the mainstay of the clinical treatment of MGD and its poor results may be often due to lack of compliance and standardization. Blephasteam wet chamber warming goggles are a promising alternative to classical warm compress treatment, potentially able to improve the effectiveness of the ‘‘warming approach.’’ 

Independent clinical study on Blephasteam

Heating wet chamber goggles (Blephasteam) in Meibomian Gland Dysfunction unresponsive to warm compress treatment.

Domenica, 01 Aprile 2012
Edoardo Villani, Fabrizio Magnani, Veronica Canton, Roberto Ratiglia

Summary:

After 3 weeks of treatment, mean OSDI score decreased from 37.7±17.5 to 23.2±12.4 and mean BUT decreased from 6.0±2.5 to 8.4±2.0 (P±2205 to 6876±1418; Pis the mainstay of the clinical treatment of MGD and its poor results may be often due to lack of compliance and standardization.  Blephasteam wet chamber warming goggles are a promising alternative.

Three month study with primarily Chinese patients aged 42-65

A Randomized, Controlled Treatment Trial of Eyelid-Warming Therapies in Meibomian Gland Dysfunction

Ophthalmol Ther. 2014 Dec; 3(1-2): 37–48.
Hui Shan Sim, Andrea Petznick, Sylvaine Barbier, Jen Hong Tan, U. Rajendra Acharya, Sharon Yeo, Louis Tong, and Collaborative Research Initiative for Meibomian Gland Dysfunction (CORIM)

Summary:

The main treatment for meibomian gland dysfunction (MGD), a major cause of dry eye, is eyelid warming. Lack of compliance is the main reason for treatment failure. This has led to the development of eyelid-warming devices that are safe, effective and convenient. To obtain robust evidence demonstrating their efficacy, the authors conducted a 3-arm randomized clinical study.  

Blephasteam® is more effective than warm towel for MGD treatment, with warm towel and EyeGiene®being comparable effective. Older age might predict for treatment efficacy. All studied therapies were safe for visual acuity (VA) for 3 months of treatment.

Adult Blepharitis Treatment study

Efficacy Of Heating Wet Chamber Goggles( Blephasteam®) In Adult Blepharitis

http://www.clinicaltrials.gov, NCT01091311
Serge Doan1, Frederic Chiambaretta2, Eric E. Gabison3, Isabelle Cochereau1, Christophe Baudouin4. 1Ophthalmology, Bichat Hospital and A de Rothschild Foundation, Paris, France;2Ophthalmology, Clermont Ferrand Hospital, Clermont Ferrand, France; 3Hopital Bichat AP-HP Cornea, Fondation A de Rothschild, Paris, France; 4Ophthalmology, Quinze-Vingts Hospital, Paris, France.

Summary:

Posterior blepharitis is a main cause of dry eye. Lid hygiene is an important treatment, but compliance is often poor because of its complexity and lack of specific devices. The aim of this study is to assess the efficacy of wet chamber warming goggles (Blephasteam®) in adult posterior blepharitis.

Blephasteam® wet chamber warming goggles are a promising alternative to classical lid hygiene techniques. A multicenter study is ongoing.

From Theory to Daily Ophthalmic practice

A supplement to Ophthalmology Times - Europe

Sponsored by Thea

Summary:

The term ‘Meibomian Gland Dysfunction’ (MGD) was first used by Korb and Henriquez in 1980, and has given impetus to the study of the disease. According to some reports, up to 70% of people suffer from MGD. Given the prevalence of the condition, which is the major cause of evaporative dry eye and possibly of dry eye overall, MGD therefore represents an important disorder in need of management.

Evaluation of the efficacy of Blephasteam goggles

Evaluation of The Efficacy, Safety, and Acceptability of an Eyelid Warming Device for the Treatment of Meibomian Gland Dysfunction

Clin Ophthalmol. 2014 Oct 6;8:2019-27.
Benitez Del Castillo JM, Kaercher T, Mansour K, Wylegala E, Dua H. 

Summary:

Global efficacy was assessed as satisfactory or very satisfactory in 83.8% of cases.

Patient-reported subjective ocular symptoms declined during the study, and a majority of patients rated the efficacy of Blephasteam as satisfactory or very satisfactory.

Most patients found the device comfortable and were able to continue with normal activities (reading, watching TV, and using a computer) during the Blephasteam session.

No safety or tolerability issues were identified.

More References

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7. C.Purslow: mettre le titre de l’étude….internal data

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12. Ghanem VC, Mehra N, Wong S, Mannis MJ. The prevalence of ocular signs in acne rosacea: comparing patients from ophthalmology and dermatology clinics. Cornea 2003; 22 (3): 230-33.