Meibomian Gland Probing (MGP) A Safe and Effective Treatment for Obstructive Meibomian Gland Dysfunction (OMGD)

Introduction

Meibomian Gland Probing (MGP) is a safe and effective procedure for treating Obstructive Meibomian Gland Dysfunction (OMGD). This article will explain what OMGD is and how it differs from “traditional” Meibomian Gland Dysfunction (MGD). We will also explore how MGP works, how it is performed, and the outcomes patients can expect. Additionally, we will discuss the frequency of probing and the safety of the procedure.

What is Obstructive Meibomian Gland Dysfunction (OMGD) and how does it differ from “traditional” Meibomian Gland Dysfunction (MGD)?

In “traditional” Meibomian Gland Dysfunction (MGD), the meibomian glands become clogged due to thickened or viscous oils. This results in back pressure, which stresses the glands and can lead to gland shortening, atrophy, and loss. This type of MGD can typically be treated with natural remedies, medications, heat therapy, and proper lid hygiene. In-office treatments such as LipiFlow, iLux, or TearCare can also be effective in clearing the clogged glands.

Obstructive Meibomian Gland Dysfunction (OMGD), on the other hand, occurs when the meibomian glands are mechanically obstructed or blocked. This obstruction can be caused by thickened meibum, cellular debris, fibrous tissue, or periductal fibrosis. These blockages prevent the flow of oils and create increased pressure behind the blockages. This pressure can result in lid tenderness, inflammation, gland shortening, atrophy, recurrent eyelid infections, and symptoms associated with dry eye, meibomian gland dysfunction, blepharitis, and ocular rosacea.

The key difference between traditional MGD and OMGD is the presence of mechanical obstructions in the meibomian glands in OMGD. While treatments like heat therapy and in-office procedures can be effective for traditional MGD, they do not provide sufficient relief for meibomian glands with fixed obstructions found in patients with OMGD.

How is Obstructive Meibomian Gland Dysfunction Diagnosed?

If a patient is not getting the expected relief from standard treatments for MGD and continues to have symptoms, recurrent infections, or signs of the condition, Obstructive Meibomian Gland Dysfunction (OMGD) should be considered. In these cases, a Diagnostic Meibomian Gland Probing can be performed to determine if mechanical obstructions are present.

During the Diagnostic Meibomian Gland Probing, the doctor probes an area of the meibomian glands to check for obstructions. This probing helps establish the diagnosis of OMGD.

How Does Meibomian Gland Probing Work/Help?

Meibomian Gland Probing (MGP) effectively treats Obstructive Meibomian Gland Dysfunction (OMGD) by mechanically clearing the obstructions or blockages in the meibomian gland ducts. This process restores the integrity and patency of the glands’ central ducts, improving gland form and function, and allowing the oil secretions to flow freely into the tear film. This relieves symptoms of ocular irritation and dryness.

Following Meibomian Gland Probing, a deep heat treatment such as LipiFlow is performed to completely clean out the meibomian gland contents. Patients are then placed on a medical regimen that includes topical antibiotic and anti-inflammatory medications to optimize the results. Additionally, patients are instructed on at-home treatments to maintain the benefits of MGP and prevent future obstructions.

How is Meibomian Gland Probing (MGP) Performed?

Meibomian Gland Probing (MGP) is a comfortable in-office procedure. The eyelids are first anesthetized using topical anesthetic drops and surgical-grade anesthetic ointment. Once the eyelids are numb, the doctor gently exfoliates all four eyelids to unclog the meibomian gland openings.

Next, ultra-fine specially designed intraductal meibomian gland probes are delicately passed through the natural openings of the glands and into the meibomian gland ducts. The probes are used to physically unclog the obstructions, and a “pop” can often be felt and heard when the obstruction is released. This confirms the presence of Obstructive Meibomian Gland Dysfunction (OMGD) and restores the patency of the gland duct.

The entire process of probing all four eyelids takes about 30 minutes and is followed by a 12-minute LipiFlow procedure. There is no downtime, and patients can return to work immediately.

Outcomes

Patients who undergo Meibomian Gland Probing (MGP) followed by a LipiFlow treatment, along with a medical regimen and home maintenance program, experience maximum symptomatic relief and long-lasting results. This treatment combination also protects against ongoing progression of damage to the meibomian glands, eyelids, and the surface of the eyes.

Studies have shown that 92% of patients experience immediate relief of their symptoms after MGP, and all patients experience relief within four weeks. The re-establishment of meibomian gland orifices and central ducts, along with the potential regeneration of damaged or missing glands, contributes to the lasting relief of symptoms.

Frequency of Meibomian Gland Probing

The frequency at which a patient may benefit from repeat meibomian gland probing depends on various factors, including the presence of coexisting ocular surface issues, the severity of these conditions, and the patient’s compliance with the prescribed medical regimen. Additionally, objective diagnostic testing and the presence of recurrent Obstructive Meibomian Gland Dysfunction (OMGD) play a role in determining the need for repeat probing.

Inflammation is known to contribute to the formation and reformation of meibomian gland obstructions, so it is important to identify and treat all sources of irritation and inflammation to minimize the possibility of future obstructions.

The specific frequency of probing will vary for each individual and should be determined by a healthcare professional based on their unique circumstances.

Safety of Meibomian Gland Probing

Meibomian Gland Probing (MGP) has been around for over 15 years, and numerous studies have been conducted to analyze its safety and efficacy. These studies, conducted in various countries, have shown that MGP is a safe and effective treatment for OMGD in patients who have not responded to standard care for MGD. No negative side effects or complications were reported in these studies.

Conclusion

Meibomian Gland Probing (MGP) is a safe and effective procedure for treating Obstructive Meibomian Gland Dysfunction (OMGD). It mechanically clears the obstructions in the meibomian gland ducts, restoring gland function, relieving symptoms, and potentially promoting regeneration of damaged glands. The frequency of probing and the long-term outcomes vary for each individual, and a healthcare professional should determine the appropriate treatment plan. Overall, MGP offers relief for patients with OMGD and protects against further damage to the meibomian glands and eyelids.