Thermal Pulsation May Be Effective for MGD and Dry Eye

A recently issued Ophthalmic Technology Assessment found that in the published literature, thermal pulsation may be safe and effective for use in patients with meibomian gland dysfunction (MGD) and dry eye. However, further study is needed.

Study Design

To fully evaluate the efficacy and safety of thermal pulsation in improving the signs and/or symptoms of MGD and dry eye compared with no therapy or conventional (nonthermal pulsation) treatments such as eyelid hygiene and warm compress, the Academy’s Ophthalmic Technology Assessment Committee Oculoplastics and Orbit Panel reviewed all studies published before March 2023 on the use of thermal pulsation to treat MGD or dry eye.

Outcomes

Eleven of the 59 studies met all inclusion criteria. No other thermal pulsation device besides Lipiflow was assessed. In 9 studies, thermal pulsation was shown to have similar or greater efficacy than conventional treatments; however, 4 of those studies had relevant industry conflicts of interest. Of the 4 level I studies with no conflicts of interest, 2 concluded that there was no significant difference in efficacy between thermal pulsation and control treatments.

Limitations

The review excluded non–English-language studies. All studies had a relatively low number of patients/eyelids in each treatment group, ranging from 16 to 99 (only 3 included >29 patients/eyelids).

Clinical Significance

Thermal pulsation may safely improve the symptoms of dry eye due to MGD in the short term; however, additional independent studies without industry support or funding are needed to confirm this. The long-term impact and cost-effectiveness of thermal pulsation also warrant further investigation.

Financial Disclosures: Dr. Nikisha Richards discloses financial relationships with Horizon Therapeutics (Consultant/Advisor).