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Background. Dry eye is a multifactor disease which needs comprehensive treatments to keep the homeostasis of ocular surface. Objective. To explore the effect of hypochlorous acid on the meibomian gland dysfunction dry eye through ultrasonic atomization. Methods. We set this study of 0.01% HOCL and 0.1% hyaluronate by ultrasonic atomization. All the data was recorded at the 1st, 15th, 30th, and 55th days. The patients’ complains, the meibum analysis, conjunctive congestion, corneal staining, Schirmer’s I test, and NIBUT were recorded by K5M, the MMP-9, and IL-2 of tear by inflammation kit; the Demodex was recorded by microscopy. Results. 53 patients have joined this study. There is no statistic difference between them on OSDI (day 15:  p = 0.061 , 30:  p = 0.055 , 55:  p = 0.052 ); results show the  10.57 ± 0.13 and  12.54 ± 0.17 reduction on OSDI; the differences of both treatments are significant ( ∗ ∗ p &lt; 0.01 ). Increased Schirmer’s and TBUT are  3.27 ± 0.10 and  6.29 ± 0.10 ( ∗ ∗ p &lt; 0.01 ) or  7.32 ± 1.72  s and  9.22 ± 1.41  s ( ∗ p &lt; 0.05 ); the decreased conjunctive and corneal staining are  0.23 ± 0.07 and  0.45 ± 0.06 ( ∗ ∗ p &lt; 0.01 ) or  0.42 ± 0.03 and  0.37 ± 0.02 ( ∗ p &lt; 0.05 ) at both groups. The differences of MMP-9 and IL-2 negative rate are significant ( Z = 0.896 ,  ∗ ∗ p = 0.002 &lt; 0.01 ;  Z = 0.659 ,  ∗ ∗ p = 0.001 &lt; 0.01 ); the number of Demodex mites at first is 10 or 11, while the last is 2 or 6 ( Z = − 4.642 ,  ∗ ∗ p &lt; 0.01 ;  Z = 2.742 ,  p &gt; 0.05 ). The Demodex count between them is significant ( Z = − 2.310 ,  ∗ p = 0.032 &lt; 0.05 ). The survival times (ST) of each stage at the HOCL are 110.75 ( 108.50 ± 24.50 ), 95.50 ( 90.25 ± 14.50 ), and 75.25 ( 73.48 ± 8.50 ) min which are shorter than those of control which are 155.50 ( 160.10 ± 21.50 ), 130.25 ( 128.25 ± 16.50 ), and 105.75 ( 102.50 ± 14.50 ) min ( ∗ ∗ p &lt; 0.01 ). The Demodex eradication rate of HOCL is statistic significant ( ∗ p 15th vs. 1st day = 0.028 &lt; 0.05 ;  ∗ ∗ p 30th vs. 1st day = 0.002 &lt; 0.01 ;  ∗ ∗ p 55th vs. 1st day = 0.0018 &lt; 0.01 ). Conclusions. 0.01% HOCL improves the Demodex eradication by shortening the survival time; the HOCL acts on the ocular surface by reducing the inflammation. The ultrasonic atomization helps for the drug usage.

Hypochlorous Acid Can Be the Novel Option for the Meibomian Gland Dysfunction Dry Eye through Ultrasonic Atomization