Treatment outcomes in patients having obstructive meiboimus gland dysfunction with chronic blepharitis

Aim: To evaluate the effectiveness of conventional treatment and intraductal meibomian gland probing, applied in addition to the conventional treatment, in patients having obstructive meibomian gland dysfunction with chronic blepharitis. Materials and Methods: Applying with symptoms of ocular surface to Cukurova University Faculty of Medicine, Department of Ophthalmology between June 2011-August 2013, 40 patients who had obstructive meibomian gland dysfunction determined in the ophthalmologic examination, were randomly divided into 2 groups. While warm compress, lid hygiene, topical and systemic antibiotics, artificial tear drops, and omega 3 fatty acid supplement were applied to the first group (20 patients, 40 eyes), in the second group (20 patients, 40 eyes), intraductal probing was performed at the first visit in addition to the treatment given to the first group. All patients were questioned about their symptoms, ocular surface disease index (OSDİ) scoring, tear break up time (BUT), Schirmer test measurements were performed. Ocular surface staining was graded according to the Oxford scheme. Moreover, pointing directly to meibomian gland dysfunction, meibum quality scoring, scoring of the morphological properties of the lid margin, and meibum expressibility scoring were performed. In the first and third months of the treatment, the efficacy of the treatment was evaluated by repeating all measurements made before the treatment. Results: The mean age of patients was 52.0±12.1 (28-79) years. While the mean age of patients in Group 1 was 51.8±12.9 years; the mean age of patients in group 2 was 52.2 ± 11.5 years (p>0.05). Compared the two groups in terms of the parameters before treatment, a statistically significant difference was not observed. When we evaluate the groups within their own; statistically significantly improvement was observed in the third month results in both groups in terms of Schirmer, OSDI scores, BUT, Oxford scoring, scoring meibum quality, lid magrin morphological changes scoring, meibum expressibility scoring (p=0.0001). When we compared the groups with each other; in terms of Schirmer test (p=0.001), BUT (p=0.014), Oxford scoring ((p=0.0001), OSDI scoring (p=0.0001), meibium quality scoring (p=0.034) and meibum ekspresibility scoring (p=0.0001) statistically significantly earlier improvement rate was observed in group 2. Only the lid margin morphological changes in terms of changes over time statistically significantly differences were not found between the 2 groups (p=0.034). Conclusions: Meibomian gland dysfunction is a treatable disease frequently encountered in the community. In our study, lid hygiene and medical treatment seem sufficient to control the disease alone, however when probing application is added to this therapy, treatment response was found to be earlier. Relief of the patients in a shorter time in this disease that requires long-term treatment, it is important in terms of improving patient motivation and compliance. Key Words: Obstructive Meibomian gland dysfunction, chronic posterior blepharitis, intraductal probing.