Comparison of a thermoelectric heating device, tea tree oil shampoo eyelid scrubs and conventional treatment in elderly patients with Meibomian gland dysfunction

Purpose: To compare the efficacy between a thermoelectric heating device (MiBoFlo Thermoflo®), tea tree shampoo eyelid scrubs and baby shampoo eyelid scrubs in elderly patients with Meibomian gland dysfunction (MGD). Materials and methods: prospective, interventional, longitudinal and comparative study. Forty-one elderly patients (82 eyes) were included. Patients were divided in three groups. Group I (n = 30): patients received 3 sessions with Thermoflo. Group II (n = 26): tea tree shampoo eyelid scrubs. Group III (n = 26): control, with baby shampoo. Ophthalmologic examination included baseline secretion test with topical anesthesia, tear break-up time (TBUT), ocular surface fluorescein staining with the Oxford scheme, Meibomian gland (MG) assessment (meibum quality and expressibility) and Ocular Surface Disease Index (OSDI) questionnaire. Evaluations were made at baseline, 4 and 8 weeks post-treatment. Repeated measures ANOVA with Greenhouse-Geisser correction was used to determine significant changes between groups. Results: There were statistically significant changes in Oxford, meibum quality and gland expressibility between the groups. OSDI score and TBUT showed improvement, but were not statistically significant. Conclusion: Apparently Thermoflo and tea tree shampoo treatments were superior for the improvement of signs and symptoms associated with MGD. Thermoflo seems superior in improving obstructive MGD due to greater gland expressibility.