Is a thermal pulsation system (LipiFlow) effective as a standalone treatment for meibomian gland dysfunction and dry eye? A systematic review and meta-analysis.
Background: Dry eye disease is a common condition that causes symptoms such as dryness, irritation, and blurry vision. The pathophysiology of dry eye disease features both aqueous deficiency (loss of aqueous tear production) and increased evaporation (loss of the lipid layer), with the latter mechan...
| Publicado en: | Therapeutic Advances in Ophthalmology pp. 1 - 21 |
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| Autores principales: | , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
5/10/2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=185067369&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 185067369 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 25158414 LAW0 jtl: Therapeutic Advances in Ophthalmology issn: 25158414 maglogo: Y pubinfo: dt: 5/10/2025 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 185067369 185067369 185067369 10.1177/25158414251338775 185067369 ppf: 1 ppct: 20 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Is a thermal pulsation system (LipiFlow) effective as a standalone treatment for meibomian gland dysfunction and dry eye? A systematic review and meta-analysis. aug: au: Chen, Kai-Yang Chan, Hoi-Chun Chan, Chi-Ming affil: Conceptualization, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan sug: subj: Meibomian Gland Dysfunction Therapy Dry Eye Syndromes Therapy Hyperthermia, Induced Equipment and Supplies Placebos Patient Safety Recovery Treatment Outcomes Evaluation Human Systematic Review Meta Analysis PubMed Medline Embase World Wide Web Confidence Intervals Odds Ratio Descriptive Statistics ab: Background: Dry eye disease is a common condition that causes symptoms such as dryness, irritation, and blurry vision. The pathophysiology of dry eye disease features both aqueous deficiency (loss of aqueous tear production) and increased evaporation (loss of the lipid layer), with the latter mechanism responsible for most of the disease presentation. Ocular surface disease (OSD) is a prevalent condition, often linked to meibomian gland dysfunction (MGD), characterized by tear film instability and symptoms like dryness and irritation. Thermal pulsation therapy, an FDA-approved treatment for MGD, uses heat and pressure to restore gland function, improving tear film stability and ocular health. Studies show its benefits last up to a year, enhancing Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), and Meibomian Glands Yielding Secretion Score (MGYSS) scores. This systematic review evaluates LipiFlow compared to placebo, warm compresses, and other devices, focusing on safety, efficacy, and its impact on recovery and long-term outcomes. Methods: A comprehensive search was performed across PubMed, MEDLINE, Embase, and Scopus until December 2024. Only randomized controlled trials (RCTs) evaluating LipiFlow were included. The primary outcomes assessed were OSDI and TBUT, with secondary outcomes including meibomian gland expression scores, corneal fluorescein staining (CFS), MGYSS, and lipid layer thickness (LLT). Meta-analyses were conducted using a random-effects model, and heterogeneity was assessed using I ² statistics. Results: Thirteen studies reported OSDI (Std diff −0.076, 95% CI −0.277 to 0.125, p = 0.255, I ² = 71.21%). Twelve studies evaluated MGYSS, showing significant improvement (Std diff 0.449, 95% CI 0.173–0.725, p = 0.001, I ² = 78.49%). TBUT results from twelve studies were not statistically significant (Std diff 0.211, 95% CI −0.017 to 0.440, p = 0.8350, I ² = 0%). CFS showed significant improvement in six studies (Std diff −0.130, 95% CI −0.248 to −0.012, p = 0.031, I ² = 0%). LLT changes were insignificant (Std diff −0.071, 95% CI −0.381 to 0.239, p = 0.653, I ² = 0%). Conclusion: LipiFlow effectively improves meibomian gland function, as indicated by TBUT, MGYSS, and CFS, but its impact on LLT and OSDI is not significant. The therapy is most beneficial for patients with severe baseline MGD. Further research is needed to establish long-term benefits and patient-specific outcomes. Plain language summary: Is a thermal pulsation system (Lipiflow) effective as a standalone treatment for Meibomian gland dysfunction and dry eye? A systematic review and meta-analysis of randomized controlled trials Dry eye disease is a common condition that causes symptoms such as dryness, irritation, and blurry vision. Many cases are linked to meibomian gland dysfunction (MGD), where the meibomian glands in the eyelids do not produce enough oil to maintain a healthy tear film. LipiFlow is an FDA-approved treatment designed specifically for MGD. It uses heat and gentle pressure to massage the eyelids, helping to unblock the meibomian glands and restore their function. Our review analyzed research studies that tested LipiFlow and compared it with other treatments, such as warm compresses or no treatment. The studies included participants who were randomly assigned to different treatment groups to ensure reliable results. The findings showed that LipiFlow significantly improves meibomian gland function, as measured by a score called the Meibomian Gland Yielding Secretion Score (MGYSS). It also reduces staining on the eye's surface, an indicator of damage caused by dryness. However, LipiFlow showed less impact on how patients reported their symptoms, such as dryness and discomfort, as assessed by the Ocular Surface Disease Index (OSDI). Another test, tear break-up time (TBUT), which evaluates the stability of the tear film, also showed minimal improvement with LipiFlow. LipiFlow appears to be most beneficial for individuals with severe meibomian gland dysfunction. While it can enhance meibomian gland health and protect the ocular surface, more research is needed to determine its long-term benefits and whether it is more effective for specific groups of patients. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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