Eyeworld

EW CORNEA 116 October 2015 Bennie H. Jeng, MD, highlighted the best cornea papers at the "Hot Off the Press" session at the 2015 ASCRS•ASOA Symposium & Congress. The papers were chosen from the Best Paper of Session winners. Here are the abstracts from the studies, with Dr. Jeng's comments regarding selection. Comparison of efficacy and convenience of warm com- presses and eyelid hygiene to thermal pulsation treatment for meibomian gland dysfunction Jack V. Greiner, DO, PhD Purpose: To evaluate the efficacy, convenience, and cost of long-term use of twice daily warm compresses and eyelid hygiene as compared to a single, in-office thermal pulsation treatment (LipiFlow, TearScience, Morrisville, N.C.), which applies simultaneous heat and pressure to the eyelids, in patients with meibo- mian gland dysfunction (MGD) and dry eye. Methods: In a prospective, mul- ticenter, open-label, randomized clinical trial, 99 subjects (197 eyes) received a single 12-minute thermal pulsation treatment and 98 subjects (196 eyes) received twice daily warm compresses (EyeGiene System, Eye- detec Medical, Danville, Calif.) and eyelid hygiene (OCuSOFT Lid Scrub, Rosenberg, Texas) for 3 mo. Subjects had MGD based on meibomian gland (MG) secretions and dry eye symptoms based on OSDI question- naire. Changes in MG secretions and dry eye symptoms scores from baseline to 3 mo. were compared be- tween groups (n=196 and 188 eyes). Compliance with use and cost of treatment were evaluated. Subjects receiving single thermal pulsation treatment were followed to 12 mo. (n=188 eyes). Results: The thermal pulsation group had significantly greater mean improvement than the compress and hygiene group from baseline to 3 mo. in MG secretions (6.2±3.7 to 17.8±10.6 vs. 6.3±3.6 to 10.8 ±8.0; p<0.0001) and dry eye symp- toms (45.6±21.1 to 21.6 ±19.8 vs. 51.8±23.1 to 33.5±25.5; p=0.0068). Over 3 mo., 15% of subjects used compresses and hygiene <7 times/ week despite 14/week instructions. Costs of compresses and hygiene for twice-daily use over 1 year vs. thermal pulsation treatment were similar. The thermal pulsation group had sustained mean efficacy at 12 mo. in MG secretions (17.3±9.1) and dry eye symptoms (21.6±21.3). Conclusion: Compared to twice daily warm compresses and eyelid hygiene over 3 months, a single thermal pulsation treatment is significantly more effective in im- proving MG secretions and dry eye symptoms, shows sustained efficacy over 1 year at a similar cost, and is more convenient without the need for daily patient compliance. Dr. Jeng: Conventional treatment of meibomian gland dysfunction includes the use of warm compresses and eyelid scrubs. One of the biggest drawbacks of this therapy, even if it works, is compliance. In this paper, the authors described their results when compar- ing eyelid hygiene to a single in-office thermal pulsation therapy. This is an important study as it not only demon- strates the short-term effects of treat- ment with thermal pulsation therapy compared to eyelid hygiene, but it also shows the lasting effects of the treat- ment out to 12 months. Combined with the lack of worry about compliance, thermal pulsation therapy seems to be very effective. However, there is a cost differential between the two treatments that is not addressed in this study. Primary pterygia excision performed via Anduze technique with mitomycin-C 0.02% applied to subconjunctival space: Review William B. Trattler, MD Hot off the press: Scan to watch video! Third in a series of 5 presentations

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