Many patients have been feeling significant relief of eye pain and discomfort with Meibomian Gland Probing with Meibomian Gland Expression.
Here are more studies showing the benefit of Meibomian Gland Probing.
In my opinion, just doing Meibomian Gland expression may not be enough to keep Meibomian Glands working for many patients. Performing a probing will break orifice scar tissue that is preventing the gland from expressing as much oil as it can.
So far 95% of my patients have had relief with one MGP procedure. I do have about 5 patients with Sjögren's syndrome that return for probing about once every 1-3 months for probing given the relief it provides. I suspect their underlying inflammation re-scars the orifice of the gland. They feel relief for a few weeks, but then the pain returns. They are praying the Stem Cell Injection into the Meibomian Gland protocol we are launching will revive Meibomian Glands and prevent the need for repeated probings.
Sandra Lora Cremers, MD, FACS
This paper below is by a fellow colleague from Harvard who has no financial interest that I know of in probing.
Dynamic Intraductal Meibomian Probing: A Modified Approach to the Treatment of Obstructive Meibomian Gland Dysfunction.
- 1
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.
Abstract
PURPOSE:
Obstructive meibomian gland dysfunction is a leading cause of ocular morbidity and its treatment remains a challenge. Meibomian gland probing was initially described in 2010. Here, the authors describe a modified technique, dynamic intraductal meibomian probing, which offers several advantages over the traditional approach including increased magnification, greater eyelid stabilization, enhanced anesthesia, and easier identification of gland orifices through the expression of meibum.
METHODS:
The authors conducted a retrospective chart review of 70 eyelids with treatment-resistant obstructive meibomian gland dysfunction undergoing dynamic intraductal meibomian probing between January 2013 and April 2015.
RESULTS:
Immediately after the procedure, 91.4% of cases experienced symptomatic improvement, and no complications were noted.
CONCLUSIONS:
Dynamic intraductal meibomian probing is an effective and safe treatment for obstructive meibomian gland dysfunction that is resistant to traditional therapies.
Cornea. 2016 Jun;35(6):721-4. doi: 10.1097/ICO.0000000000000820.
Effectiveness of Intraductal Meibomian Gland Probing for Obstructive Meibomian Gland Dysfunction.
Abstract
PURPOSE:
To evaluate the short-term effectiveness of intraductal meibomian gland probing using modified Maskin cannulas in patients with obstructive meibomian gland dysfunction.
METHODS:
The study prospectively included 58 eyes of 30 patients with a diagnosis of meibomian gland dysfunction who were refractory to medical treatment for at least 6 months. The patients were divided into 4 groups according to the number of probing procedures applied. During probing, sterile modified Maskin probes 2, 2.5, 4, and 6 mm in length were used. A tarsal massage was recommended after medical treatment. Preoperatively, then postoperatively at 1 week, 1 month, and 3 months, the Schirmer 1 test was performed, tear break-up time was measured, and images of the anterior segment were recorded. In addition, the Ocular Surface Disease Index questionnaire was completed at baseline and at 3 months.
RESULTS:
In all groups, there were no statistically significant differences between Schirmer 1 test results at preoperative and postoperative 3 months, but tear break-up time values measured at baseline and at 3 months differed significantly (5 seconds, 13 seconds, P < 0.001). In the analyses of anterior segment photographs of all patients, statistically significant postprocedural decreases in conjunctival hyperemia (P < 0.0001) and eyelid margin vascularization (P = 0.004) were detected, and the later Ocular Surface Disease Index scores showed a significant improvement between preop and 3 months.
CONCLUSIONS:
A procedure using modified Maskin probes was effective and reliable in the short term for patients with meibomian gland dysfunction.
Cornea. 2016 Jun;35(6):725-30. doi: 10.1097/ICO.0000000000000777.
Efficacy of Intraductal Meibomian Gland Probing on Tear Function in Patients With Obstructive Meibomian Gland Dysfunction.
- 1
- Department of Ophthalmology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Abstract
PURPOSE:
To assess the efficacy and safety of intraductal meibomian gland probing in patients with obstructive meibomian gland dysfunction who experienced little improvement with eyelid warming, massage, or artificial tears.
METHODS:
Forty-nine patients with obstructive meibomian gland dysfunction were randomly divided into 2 groups: intraductal meibomian gland probing with 0.1% fluorometholone (group I), and 0.1% fluorometholone alone (group II). Subjective symptom scores and objective signs, including lid margin abnormalities, meibum quality and expressibility, meibomian gland dropout, fluorescein staining, tear break-up time (TBUT), and Schirmer I test results, were recorded before treatment and after 1 day, 1 week, and 1 month posttreatment.
RESULTS:
Clinical subjective symptoms and objective signs including meibum grade, TBUT, lid margin abnormalities, and fluorescein staining demonstrated significant improvements in both groups after treatment over time (all P < 0.05), and group I was better than group II 1 month after treatment in meibum grade (6.1 ± 3.3 vs. 10.4 ± 4.9, respectively; P < 0.001), lid margin abnormalities (0.8 ± 0.1 vs. 1.3 ± 0.3, respectively; P < 0.001), and TBUT (8.2 ± 2.1 vs. 7.0 ± 3.0, respectively; P = 0.0293). Before applying any medications, 76% of patients obtained immediate symptom relief 1 day after probing. However, the Schirmer I test results and meibomian gland dropout were insignificant pre- and posttreatment in either group (P > 0.1, respectively).
CONCLUSIONS:
Intraductal meibomian gland probing demonstrated significant efficacy in symptom relief and tear film stabilization. Probing helped release accumulated meibum and could help increase the accessibility of diseased meibomian glands to topical corticosteroids.
Cornea. 2015 Oct;34(10):1206-8. doi: 10.1097/ICO.0000000000000558.
Analysis of Meibum Before and After Intraductal Meibomian Gland Probing in Eyes With Obstructive Meibomian Gland Dysfunction.
Abstract
PURPOSE:
To evaluate whether the amount of meibum and its viscosity change after intraductal meibomian gland probing in patients with refractory obstructive meibomian gland dysfunction (o-MGD).
METHODS:
Six lid margins of 3 patients with refractory o-MGD underwent intraductal meibomian gland probing. Meibum and the clinical outcome were evaluated before the procedure and at a 1-month postoperative visit. Meibum was quantified with a Meibometer, and its viscosity (Shimazaki grade) was assessed simultaneously. The tear film condition was evaluated by lipid layer interferometry (DR1, Kowa, Nagoya, Japan), and meibomian gland loss was analyzed by noncontact infrared meibography. Lid margin findings, tear break-up time, fluorescein score, and ocular symptoms were also assessed.
RESULTS:
At the postoperative visits, all cases showed improvements in meibum lipid levels (446-1376, 757-802, and 396-571 meibometer units) and meibum viscosity (grade 3-0, 3-1, and 3-2). Two cases showed an improvement in tear break-up time (2-5 and 0-6 seconds). No morphological changes in the meibomian gland were observed in any cases.
CONCLUSIONS:
Intraductal meibomian gland probing seems to improve meibomian gland lipid levels, and it may be a good treatment option for cases of o-MGD that are resistant to conventional treatment.
Hi! I am doing a review of the literature on the Maskin probes for intraductal MG probing. Do you know if the Syed et al. study on DIMP used the Maskin probes?
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