45
EW CORNEA
June 2016
Contact information
Holland: eholland@holprovision.com
Perry: hankcornea@gmail.com
Wladis: tedwladis@gmail.com
these antibiotics until a prospective
study is done.
"When you first look at the
abstract, you get a sense that maybe
there are several studies that showed
a failure of oral antibiotics for the
treatment of MGD, which is not
true. It's just there haven't been pro-
spective trials," Dr. Holland said.
"Of course, we'd love to have
multiple, large, prospective clinical
trials to prove everything we do in
medicine is validated, but we don't
often have that," he continued.
"Sometimes we have to go by our
clinical experience. Our clinical
experience—and anyone who takes
care of this disease—would tell us
that macrolides are very effective
treatment for meibomian gland
disease."
Dr. Wladis said this study is not
advocating for the discontinuation
of these antibiotics, but rather for a
well-designed prospective study to
occur to provide hard data on the
topic. Until then, he said physi-
cians should have a conversation
with their patients about these
antibiotics. In fact, the published
investigation indicated that most
studies demonstrated a benefit to
antibiotics, although they were not
a panacea.
Dr. Wladis reiterated that the
article published by him and his
coauthors did not contain a sin-
gle statement suggesting that oral
antibiotics should not be used until
a larger study is conducted to supply
more data.
"Instead, we sought to point
out that these large studies have not
been done and that they represent
a fertile area of research to help pa-
tients who are in need," Dr. Wladis
said.
"I reach for oral antibiotics
for my patients almost every day,
but I do think physicians need to
have very open conversations with
patients that there isn't a tremen-
dous body of evidence that shows
in a very significant way that these
antibiotics knock out every aspect
of meibomian gland disease," he
said. "Physicians need to have open
and honest conversations with their
patients about which benefits they
can expect and the fact that there
might be some benefits that are out
of reach with these agents." EW
References
1. Bron AJ, et al. The contribution of mei-
bomian disease to dry eye. Ocul Surf.
2004;2:149–65.
2. Wladis EJ, et al. Oral antibiotics for meibo-
mian gland-related ocular surface disease: a
report by the American Academy of Ophthal-
mology. Ophthalmology. 2016;123:492–96.
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