Terapia termiczna EyeBag w leczeniu zespołu suchego oka w przebiegu niewydolności gruczołów Meiboma
EyeBag Warm Compress in Treatment of Dry Eye Syndrome Secondary to Meibomian Gland Dysfunction
Katarzyna Szymanek1,2, Piotr Szymanek1, Anna M. Ambroziak2,3
1 ACL-VISION Specjalistyczne Ambulatorium Okulistyczne, Niepubliczny Zakład Opieki Zdrowotnej
2 Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
3 Zakład Optyki Informacyjnej Instytutu Geofizyki Wydziału Fizyki Uniwersytetu Warszawskiego Kierownik: dr hab. Rafał Kotyński
Summary: Material and methods: The study included 50 patients (100 eyes; 38 females and 12 males) with dry eye syndrome secondary to Meibomian gland dysfunction who were subject to thermotherapy including the use of Eye-Bag warm compress and lid massage. Contact lens wearers (18 subjects; 10 soft CLs, 8 RGP) were identified in the study group. The mean age was 49.4 years (36.1 in the contact lens wearers group and 54.8 for the other subjects). The evaluated parameters were: the outflow from Meibomian glands and the quality of secretions based on the eight central glands in the lower eyelid, tear film break-up time, corneal fluorescein staining subjective symptoms using the OSDI Qestionnaire and thermotherapy tolerance level. The subjects underwent examination and were asked to complete the questionnaire after 2 and 8 weeks of therapy.
Results:Following two weeks of EyeBag warm compress therapy (twice a day x 10 minutes) a significant improvement of the lid margins was observed the severity of Meibomian gland dysfunction was reduced from 2.903 to 1.569 on the scale. Tear film break-up time was extended from 3.4 sec. to 5.5 sec. and staining according to corneal fluorescein staining was reduced from 1.3 to 0.7. Subjective symptoms were reduced by 40% (baseline OSDI was 43.4, and decreased 25.5 following two weeks of therapy). The subjects rated the tolerance of Eye-Bag warm compress therapy as “very good” (48%), “good” (45%), “satisfactory” (7%) and none of the patients rated it as “unsatisfactory”. In the contact lens wearers sub-group the improvement of all study parameters (lid margins, tear film break-up time, corneal fluorescein staining) was even more significant and the subjective improvement according to the OSDI form was more profound. Following another 8 weeks of therapy (once a day x 10 minutes) the study parameters and subjective evaluation improved further and the slight difference between contact lens wearers and non-wearers was still observed. The therapy was well tolerated by the patients and there were no complications related to the application of EyeBag warm compresses.
Conclusions: The lipid layer provides integrity and stability to the tear film and prevents evaporation of the aqueous layer. As a result of Meibomian gland dysfunction the lipid layer is compromised and evaporative dry eye syndrome develops. EyeBag warm compress therapy increases the outflow from the Meibomian gland and improves the quality of secretions, which results in better clinical condition of the patient and reduction of the subjective symptoms. It is a safe and effective method to treat and alleviate dry eye syndromes secondary to Meibomian gland dysfunction. The improvement observed in contact lens wearers was more profound than among other patients.
Słowa kluczowe: termoterapia, EyeBag, kompres termiczny, zespół suchego oka – ZSO, dysfunkcja gruczołów Meiboma – MGD.
Keywords: thermotherapy, Eye-Bag, warm compress, dry eye syndrome – DES, Meibomian gland dysfunction – MGD.