Thermal Devices Effectively Relieve Dry Eye Symptoms in Patients With Meibomian Gland Dysfunction

Meibomian Gland, LM
Light micrograph showing the Meibomian gland of a normal eyelid (also known as a tarsal gland).
The lid warming therapy devices offer patients with meibomian gland dysfunction similar results at 1 month.

Patients who undergo TearCare® (Sight Sciences, Inc.) treatments can experience comparable outcomes to those treated with the Lipiflow® Thermal Pulsation System (Johnson & Johnson Vision),  according to a study published in Cornea. The investigation evaluated both signs and symptoms of patients with dry eye disease (DED) associated with meibomian gland dysfunction (MGD) at 1 month after treatments. 

Investigators conducted a multicenter, masked, controlled study of 135 participants who reported dry eye symptoms within the past 3 months and randomly assigned them to either the Lipiflow group (n=68, mean age 52.3±15.1) or TearCare group (n=67, mean age 56.1±13.7). They performed a tear break up test (TBUT), obtained corneal staining and meibomian gland secretion scores (MGSS), and administered the Ocular Surface Disease Index (OSDI) questionnaire to all participants. Mean baseline TBUT and MGSS scores were 4.6±1.2 s and 6.5±3.1 and 4.5±1.0 s and 6.3±2.7 for the TearCare and Lipiflow treated groups, respectively.

Researchers conducted follow up visits at 2 weeks and 1 month. TBUT increased in the TearCare group by 2.74±4.0 seconds and 3.02±0.44 seconds and by 2.19±2.46 seconds and 2.58±3.2 seconds in the Lipiflow group following treatment at the initial and final follow up visits, respectively. MGSS also increased with a change from baseline of 10.47±10.89 and 11.20±11.13 in the TearCare group and 10.72±9.76 and 11.09±10.41 in the Lipiflow groups at 2 week and 1 month follow up, respectively.   

Investigators noted a decrease in corneal staining in both groups, but it only achieved statistical significance in the TearCare group (P <.05). Although no participant reported any serious complications resulting from treatment, 3 participants from the TearCare group and 4 patients from the Lipiflow group experienced minor device-related events that did not require further management. There were no differences in pain, surface staining, intraocular pressure (IOP), and best-corrected visual acuity (BCVA) between the 2 groups.

“A stable and normal functioning tear film is the key to maintaining the health of the ocular surface,” the investigators note. Since debridement and gland expression are not always effective or comfortable for the patient, “Medical device innovations designed to deliver controlled, thermal therapy to the eyelids to sufficiently liquefy hardened meibum and clear gland obstructions have been gaining traction.”

Study limitations include reliance on self-reported, subjective measurements and a lack of long term follow-up.

Disclosure: One of the study authors declared an affiliation with Sight Sciences, Inc. Please see the original reference for a full list of authors’ disclosures.


Gupta PK, Holland EJ, Hovanesian J, et al. TearCare for the treatment of meibomian gland dysfunction in adult patients with dry eye disease: a masked randomized controlled trial. Cornea. 2022;41(4):417-426. doi:10.1097/ICO.0000000000002837