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Effects of topical loteprednol etabonate on tear cytokines and clinical outcomes in moderate and severe meibomian gland dysfunction: randomized clinical trial

 Hun Lee  ;  Byunghoon Chung  ;  Kyu Seo Kim  ;  Kyoung Yul Seo  ;  Bong Joon Choi  ;  Tae-im Kim 
 AMERICAN JOURNAL OF OPHTHALMOLOGY, Vol.158(6) : 1172-1, 2014 
Journal Title
Issue Date
Administration, Topical ; Adult ; Aged ; Aged, 80 and over ; Androstadienes/administration & dosage ; Androstadienes/therapeutic use* ; Anti-Allergic Agents/administration & dosage ; Anti-Allergic Agents/therapeutic use* ; Bandages ; Cytokines/metabolism* ; Eye Proteins/metabolism* ; Eyelid Diseases/classification ; Eyelid Diseases/drug therapy* ; Eyelid Diseases/metabolism ; Female ; Flow Cytometry ; Humans ; Loteprednol Etabonate ; Male ; Meibomian Glands/drug effects* ; Meibomian Glands/metabolism ; Middle Aged ; Ophthalmic Solutions ; Prospective Studies ; Surveys and Questionnaires ; Tears/metabolism*
PURPOSE: To assess tear cytokine levels and clinical outcomes in moderate and severe meibomian gland dysfunction (MGD) after 2 months of treatment with topical loteprednol etabonate and eyelid scrubs with warm compresses vs eyelid scrubs with warm compresses alone.

DESIGN: Randomized controlled trial.

METHODS: Patients with moderate and severe MGD were randomized into 2 groups: topical loteprednol etabonate and eyelid scrubs with warm compresses (Group I, 34 eyes) or eyelid scrubs with warm compresses (Group II, 36 eyes). We evaluated cytokine levels, tear film break-up time (TBUT), corneal and conjunctival fluorescein staining, biomicroscopic examination of lid margins and meibomian glands, and the Ocular Surface Disease Index before initiating treatment and 1 month and 2 months after treatment.

RESULTS: There were significant decreases in the levels of interleukin (IL)-6, IL-8, and IL-1β in Group I, and IL-6 and IL-8 in Group II. Moreover, the observed decreases of these cytokines in Group I were attributed to a remarkable decrease between treatment and 1 month after treatment. In Group I, there were improvements in all of the clinical outcomes, with prominent improvement in TBUT, corneal and conjunctival fluorescein staining, and meibum quality after 1 month of treatment, compared with Group II. An improvement in meibomian gland expressibility and MGD stage reduction were more remarkable in Group I.

CONCLUSIONS: Topical loteprednol etabonate and eyelid scrubs with warm compresses were tolerated and efficacious for the treatment of moderate and severe MGD. We suggest that such beneficial effects could manifest after 1 month.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae-Im(김태임) ORCID logo https://orcid.org/0000-0001-6414-3842
Seo, Kyoung Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
Lee, Hun(이훈)
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