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Meibography guided intraductal meibomian gland probing using real-time infrared video feed
  1. Steven L Maskin,
  2. Sreevardhan Alluri
  1. Dry Eye and Cornea Treatment Center, Tampa, Florida, USA
  1. Correspondence to Dr Steven L Maskin, Dry Eye and Cornea Treatment Center, Tampa, FL 33609, USA; drmaskin{at}tampabay.rr.com

Abstract

Purpose To evaluate use of infrared meibography video to visualise meibomian gland probing and correlate probe findings of intraductal space with meibography images.

Methods Videos were reviewed and probe findings recorded of 996 probed gland orifices from 38 lower lids.

Results 996/997 (99.9%) of gland orifices were successfully probed with 91.8% revealing probe location. There were no false passages. 14% (140/997) of all gland orifices showed whole gland atrophy (WGA) with 99.3% (139/140) probed to 1 mm. Cumulative probe findings for all WGA (not differ significantly from non-WGA) showed 106 (76%), 21 (15%) and 12 (9%) glands with fixed, non-fixed and no resistance (NR), respectively. Lids without WGA showed increased NR/total glands probed while lids with WGAs (≥5) showed increased NR/WGA compared with lids with only 1–4 WGAs (p=0.011, p=0.005, respectively, Mann-Whitney U test) suggesting bimodal NR profile. Visualisation of microtube placement was successfully obtained for therapeutic injections and retrieval of meibum specimens.

Conclusion Video confirmed intraductal location and safety of devices. For 73% of non-WGA and 76% of WGAs as well as proximal ducts of glands with proximal atrophy, probing released fixed resistance restoring ductal integrity. A bimodal profile of NR suggests it is found with less diseased gland ducts as well as more advanced atrophic gland disease. Gland and ducts appeared flexible but not distendable while periglandular tissue appeared spongy. Visualisation of devices enables whole or localised gland therapy and meibum specimen retrieval, elegantly raising future research, therapeutic and regenerative opportunities.

  • cornea
  • eye lids
  • inflammation
  • ocular surface
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors SLM and SA planned and conducted the study, analysed the data as well as drafted and revised manuscript. SA performed statistical analysis. SLM is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests SM is the owner of MGD Innovations, Inc which holds patents on instrumentation and methods for intraductal diagnosis and treatment of meibomian gland disease (MGD), plus related pending patents including visualisation of real-time intraductal diagnostics, probing and other therapies. SM also has patents on the use of jojoba-based treatment options for MGD.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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