Review of Literature on Intraductal Meibomian Gland Probing with Insights from the Inventor and Developer: Fundamental Concepts and Misconceptions.

IF 1.8 Q3 OPHTHALMOLOGY Clinical ophthalmology Pub Date : 2023-02-08 eCollection Date: 2023-01-01 DOI:10.2147/OPTH.S390085
Natalia A Warren, Steven L Maskin
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Abstract

Obstructive Meibomian gland dysfunction (MGD) affects millions of patients around the world. Its effective treatment with intraductal meibomian gland probing (MGP), was first reported in 2010. Since then, MGP has provided relief to thousands of patients globally suffering with refractory MGD. The purpose of Meibomian gland probing is restoring the integrity of the gland's central duct by entering the gland through the natural orifice, releasing fixed obstruction thought to be periductal fibrosis, thereby establishing and/or confirming the patency of the duct, and concurrently equilibrating intraductal pressure as well as promoting gland functionality with meibum production. There may or may not be immediate secretion of meibum upon successful restoration of ductal integrity depending on the gland's state of function and degree of atrophy. One double-blind placebo-controlled study has been conducted and, with the accumulated evidence of over 12 other peer reviewed articles in the scientific literature, overwhelmingly indicates that MGP is a safe and effective treatment for the MGD patient refractory to prior standard care and as a first-line treatment. This paper describes relevant fundamental concepts, dispels commonly held misconceptions, and provides an objective review of the current understanding and effectiveness of MGP for the treatment of obstructive MGD. Our analysis will better equip clinicians to draw informed conclusions about both subjective and objective findings reported in MGP studies and researchers to design future robust studies that provide meaningful results.

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关于导管内睑板腺探查术的文献综述以及发明者和开发者的见解:基本概念和误解。
阻塞性睑板腺功能障碍(MGD)影响着全球数百万患者。2010年首次报道了通过导管内睑板腺探查术(MGP)进行有效治疗的方法。从那时起,睑板腺探查术已为全球数以千计的难治性睑板腺疾病患者解除了痛苦。睑板腺探查术的目的是通过自然孔道进入腺体,解除被认为是导管周围纤维化的固定阻塞,恢复腺体中央导管的完整性,从而建立和/或确认导管的通畅性,同时平衡导管内压力,促进腺体功能,分泌睑板腺素。根据腺体的功能状态和萎缩程度,在成功恢复导管完整性后,可能会也可能不会立即分泌meibum。目前已进行了一项双盲安慰剂对照研究,加上科学文献中超过 12 篇其他同行评审文章的累积证据,压倒性地表明 MGP 是一种安全有效的治疗方法,可用于治疗之前的标准治疗方法难治的 MGD 患者,并可作为一线治疗方法。本文阐述了相关的基本概念,消除了人们普遍持有的误解,并对目前治疗阻塞性马格尼德氏病的 MGP 的理解和有效性进行了客观的评述。我们的分析将更好地帮助临床医生对MGP研究中报告的主观和客观结果做出明智的结论,并帮助研究人员设计未来的稳健研究,以提供有意义的结果。
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来源期刊
Clinical ophthalmology
Clinical ophthalmology OPHTHALMOLOGY-
CiteScore
3.50
自引率
9.10%
发文量
499
审稿时长
16 weeks
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