Immediate sequential changes in the tear film lipid layer following eyelid massage in dry eye syndrome: a comparative control study

Jiayan Chen, Sile Yu, Guanghao Qin, Salissou Moutari, Jonathan E. Moore, Ling Xu, Wei He, Emmanuel Eric Pazo*, Xingru He*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background /Purpose: Meibomian glands are sebaceous glands that release meibum onto the ocular surface; enhancing the quality and quantity of meibum secretions has been proven to improve signs and symptoms of evaporative dry eye (EDE) and meibomian gland dysfunction (MGD). This study aimed to evaluate and compare the efficacy of a heated eye mask (HEM) and eyelid massage device EyePeace (EP) in alleviating signs and symptoms of evaporative dry eye. Methods Forty dry eye participants were recruited in a prospective, contralateral-eye trial study. After undergoing 10 min of HEM therapy, eyelid massage therapy was applied to one eye by the device. The efficiency was assessed at four time points: baseline (0 mins), 5 minutes (5 mins), 15 minutes (15 mins), and 30 minutes (30 mins).. Non-invasive breakup time (NITBUT), redness score(RS Score), tear meniscus height (TMH), tear-film lipid layer (TFLL), endothelial cell count (ECC), meibomian gland expressibility (MGEx), meibomian gland quality (MGQ), conjunctivocorneal staining (CS), ocular surface temperature (OST), best corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness (CCT) flat-axis keratometry value (K1), and steep-axis keratometry value (K2), were examined. Results Baseline clinical measurements did not have statistically significant differences between the groups (all p > 0.05). After 30 minutes, a comparison was made between the HEM group and EP+HEM group, revealing significant changes only in the primary outcomes, TFLL (2.18±0.45 versus 2.40±0.50; p < 0.05), and MGEx grades (0.68±0.53 versus 0.98±0.70; p < 0.05). Improvements in NITBUT and TMH were sustained until 5 mins and 15 mins after using EP+HEM. No significant changes were observed in RS Score, MGQ, OST, CFS, BCVA, IOP, ECC, K1, K2, and CCT (all p > 0.05) at all test time points. Conclusion The application of a heated eye mask followed by a gentle massage using EyePeace on the eyelids can have a sustained improvement in the tear film lipid layer and meibomian gland expressivity score but not clinically significant, and does not pose any significant immediate impact on the cornea.
Original languageEnglish
Article numbere36590
JournalHeliyon
Early online date20 Aug 2024
DOIs
Publication statusEarly online date - 20 Aug 2024

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