Eyeworld

29 EW CORNEA January 2015 Before treatment, the groups were similar in age and gender as well as clinical and microscopy sta- tus, she said. This is important in a retrospective study in which patients may have been treated differently based on differences in presentation, which can introduce bias. Overall, both treatments were effective. "Both groups showed significant improvements in OSDI scores, increased tear break-up time, and improvements in gland morphology by microscopy," she said. The only between-treatment difference was a greater decrease in meibomian gland diameter in the goggles group compared to the hot towel group. Also, "based on the previously validated OSDI Minimal Clinically Important Difference, we found 4 subjects in the hot towel group and only 1 in the goggles group that showed no improvement in OSDI scores." Practical implications These data support the role of lid warming for symptomatic MGD. "The lipids deficient in dry eye, such as OAHFAs, are increased by lid warming treatment," concluded Dr. Tong. "The change in 2 lipids cor- relates to the extent of symptomatic improvement. Also, lipid changes correlate to the change in tear evaporation, suggesting a functional role of lipids in MGD." Dr. Canton agreed. "Eyelid warming is the mainstay of the treatment of mild to moderate MGD." While there were few differences between the hot towel and goggles groups in her study, she did point out that there might be value in using "devices that are able to increase standardization and compliance to therapy." EW References Canton V, Garoli E, Villani E, et al. Comparative analysis of clinical and confocal outcomes in patients with meibomian gland dysfunction treated with warm compresses versus wet chamber warming goggles: a retrospective study. ARVO 2014 annual meeting abstract. Sim HS, Petznick A, Tong L, et al. A Random- ized, Controlled Treatment Trial of Eyelid- Warming Therapies in Meibomian Gland Dysfunction. Ophthalmol Ther. 2014 Aug 26. [Epub ahead of print] Yeotikar NS, Zhu H, Omali NB, et al. The natural history of meibomian glands: Age-re- lated changes in an asymptomatic population. Invest Ophthalmol Vis Sci 2014;55: E-Abstract 21, ARVO 2014 annual meeting abstract. Editors' note: Drs. Canton, Tong, and Yeotikar have no financial interests related to their comments. Contact information Canton: veronica.canton@libero.it Tong: Louis.tong.h.t@snec.com.sg Yeotikar: n.yeotikar@brienholdenvision.org Reference: 1. Data on file. LENSAR, Inc. The LENSAR Laser System – fs 3D (LLS-fs 3D) is intended for use in patients undergoing cataract surgery for removal of the crystalline lens. Intended uses in cataract surgery include anterior capsulotomy, laser phacofragmentation, and the creation of full and partial thickness single-plane and multi-plane arc cuts/incisions in the cornea, each of which may be performed either individually or consecutively during the same procedure. Laser Capsulotomy, laser phacofragmentation and/or corneal incisions surgery is contraindicated in patients: who are of pediatric age, whose pupils will not dilate or remain dilated to a diameter greater than that of the intended treatment and for capsulotomies and/or laser phacofragmentation with intended diameters of less than 4 mm or greater than 7 mm, who have existing corneal implants, who have previous corneal incisions that might provide a potential space into which the gas produced by the procedure can escape, who have conditions that would cause inadequate clearance between the intended capsulotomy cut and the corneal endothelium, such as: hypotony, uncontrolled glaucoma, who have corneal disease or pathology that precludes transmission of light at the laser wavelength or causes distortion of laser light, such as: corneal opacities, residual, recurrent, active ocular or uncontrolled eyelid disease or any corneal abnormalities (including endothelial dystrophy, guttata, recurrent corneal erosion, etc.) in the eye to be treated, ophthalmoscopic signs of keratoconus (or keratoconus suspect) in the eye to be treated, a history of severe dry eye that has not responded to therapy, a history of herpes zoster or herpes simplex keratitis. Potential contraindications are not limited to those included in the list. WARNING: The safety and effectiveness of this laser have NOT been established in patients with diabetic retinopathy, a history of treated glaucoma, or prior intraocular surgery. © 2014 LENSAR, Inc. All rights reserved. LENSAR and the LENSAR logo are registered trademarks and Augmented Reality is a trademark of LENSAR, Inc. 50-00078-000 Rev. B 09/14 The LENSAR ® Laser System can help you make all the right moves in femtosecond laser cataract surgery. That's because LENSAR was thoughtfully designed from the ground up to meet the needs of cataract surgeons, with unique features that increase workflow and procedural efficiencies, reduce CDE up to 100%, 1 and create a safe patient experience. And now with pending capabilities to connect with pre- and post-op diagnostics, LENSAR can help you further refine outcomes for increased accuracy and greater patient satisfaction. Learn more about LENSAR's winning combination of features at www.LENSAR.com. THINK STRATEGIC

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