Meibomian glands diagnostic expressibility: a new diagnostic medical device

Abstract Purpose To assess the expressibility of the meibomian gland we proposed a new diagnostic tool. We evaluated the use of the instrument by assessing the time of the meibomian gland expressibility and the intraocular pressure change in two groups of healthy patients. Methods We selected two groups of patients divided according to age. The first group consisted of 45 subjects aged between 20 and 30 years (mean 28 ±4.5 yrs) and a second group (group B) of 45 subjects aged between 40 and 50 years (mean 46±3.8 yrs). Meibomian gland evaluations were performed using a standardized technique with an evolved new diagnostic instrument patented in Italy. The instrument has a rectangular contact surface area of 40.57 mm2. The head surface is covered with a plastic film that is changed at each examination. The instrument exerts a constant pressure of 1.2 gr/mm2 under piezoelectric control. We evaluated the time to onset of fluid at the orifices of the meibomian glands and changes of intraocular pressure (IOP) after compression of the lower eyelid with applanation tonometry. Results In the group A and in group B the time to onset the fluid was 3.69±1.22 vs. 6.62±1.39 sec. (p<0.001). The IOP before and after compression of the eyelid was 14±1.13 vs. 23.4±2.0 mm/Hg (p<0.001). The mean number of meibomian gland secretion in each third of the lower eyelid were significantly different (p<0.001). Temporal: 1.29±0.13, central: 2.72±0.11, nasal: 3.51±0.14. Conclusion Our custom diagnostic meibomian gland expression instrument that is an evolution of other proposed devices has proved effective in evaluating the expressibility of the meibomian gland with a small increase of the intraocular pressure.