Ineresting procedure for closed meibomian glands

[pj95]

Never heard of anything like this before but check out this video. It shows a doctor opening up meibomian glands with a needle like tool. Has anyone else heard of this procedure?http://www.youtube.com/watch?v=YV130urz4ME

[bassfan]

Never seen that before!!!...pretty freaky.

[soxboy]

Hello everyone....I have had Bleph/dryeye for the better part of my life. I am 38 now and have been a patient of Dr. Lakany's before. I have often wondered why a procedure like this has never been shown before. I guess my only question would be , how often would you have to get this done. It looks like such a relief. Bleph/dry eye is the worse thing I have ever expierenced in my life. I have never been able to control it. It looks like and feels like I got into fights every morning I wake up and every evening after about 7-8 pm. It is a constant struggle, and really hurts ones confidence and appearence. I pray for a cure everyday. I would get this proceedure done tomorrow if I could. Thanks for listening to me vent......

[Rojzen]

meibomian gland piercing

Fascinating procedure, and I have so often imagined myself finding a device that would enable me to do that to myself!

The concept seems smart, and it is the first procedure I've seen that addresses the problem of metaplasia, or abnormal skin growth, over the gland openings, mechanically. Retinoic acid (a chemical peel) has been used with some success to remove the unwanted blocking tissue, but this piercing procedure is so direct and immediate in effect. . .

The problem, for me and others, is that merely reopening a sealed exocrine gland may not restore normal gland function. My understanding is that one reason a meibomian gland may seal up in the first place is that the below-surface gland tissue has atrophied or "dropped out," such that a separate process would be needed in order to reactivate gland function even if the metaplasia is stripped off. Retinoic acid is believed to have effects on the DNA that governs gland secretion, and so it was hoped, with the retinoic acid, that it could peel off the metaplasia and also stimulate gland regeneration and function, and I know of a few cases in which this has indeed happened. . .

Anyway, I think the mechanical piercing is definitely worth a shot for anyone who has blocked glands, since one never knows just how atrophied one's glands may or may not be. . .

Sterile preparation and careful sizing of the piercing instrument, of course, would seem absolutely essential. . .along with immense precision/care by the doctor performing this so close to the delicate ocular surface. . .

[Lucy]

As Rojzen mentions, "sterile conditions....... .along with immense precision/care by the doctor performing this so close to the delicate ocular surface. . ."

This sort of made me queasy! Did you notice the blood afterward? As they say on "Pipley's Believe it or Not", please do not try this at home. It looks very painful and this doc was just jabbing quicky along. Looks like he/she had lots of experience.

Would be interesting to hear a report from anyone who has had it done before.

Lucy

[GeorgeT]

Hi,

As Lucy pointed out the doctor shows a lot of experience with this procedure. This may mean that this procedure works. Actually the oil coming out from meibomian glands was not very thick, as we can easily observe it flowing after procedure. I am not sure if I can make an inference here, but seems only the orifice is clogged (or capped like my doctor says). "Singh" sounds like an indian name.
Does Dr.Latkany know this procedure?

All best !!

George

[pj95]

The Dr. who performed the procedure is Daljit Singh a doctor in India. I did some research and it seems that he is a highly touted Dr. It seems that it may be that the procedure it not yet known by domestic doctors. From what I have read, Dr. Singh does this procedure on one eye at a time then waits to see the result. In one case the patient felt so much relief that he came back the next day to get the other eye done. I am very intrigued. I would also like to know Dr. Latkany's thoughts on this.

[sai1930]

That is one scary video. Wonder why the doctor was puncturing the holes in such a hurry, could be a medical reason i guess..

Anyway, I found this link where he talks about this procedure, (Not much info, but there is a link to his mail/website)

http://health.groups.yahoo.com/group...y/message/1203

[calli66]

Sai1930, I agree with you--the whole thing went very fast. I couldn't tell if it was just a speeded-up video/low resolution, or if the doctor was doing it that fast. In any case, I wasn't sure he was poking into the actual plugged openings, or just punching along the eyelid hit-or-miss. Hard to tell. I don't recall seeing blood....but I would worry that bacteria would get introduced into the tissue and cause infection.

Calli

[ronny]

i have been wondering why something like this couldnt be done for years now. I also wonder why some sort of miniture shunts couldnt be used to keep the glands open. For gods sake, we can take a heart out of 1 person stick it into another, and they can live a fairly normal life. but they cant figure out how to get tears into a persons eyes. makes no sense, just a total lack of understanding as to how debilitating this problem is.

[sai1930]

Hi Ronny - My thoughts exactly. I guess the problem is lack of research so far. The last section of Robert Latkamy's book highlights, how sudden interest has been gathered on this subject & the research that Pharma Companies are doing on this.
So i hope we will find relief soon, & i truly believe in Roberts motto "Not a DryeEye in the house"

[calli66]

I looked at several videos of eye operations that Dr. Singh has published to the web. He is using a "Fugo blade" (some sort of laser) for opening the meibomian glands. One of the videos shows a more precise aiming at the plugged glands with some bleeding involved. The patients appear to have extreme blockage, swollen lids---in dire need of relief. I would imagine there would be pain and swelling during the healing process. There is no mention or photos of the patients' eyes during or after healing----no details. For example, what was the underlying condition that caused the plugged glands; what measures were taken so that they do not become plugged again?

It almost seems to be a case where some surgeons have a new "toy," and are putting out these short videos in their own community--"Look, I used it for this!" and "Wow, you did that? I used it for something different!"

Calli

[Rebecca Petris]

Has anyone come across text information or publications about the treatment? The YouTube thing is titled Meibomian Fugolysis but I found absolutely nothing on the search engines under that name except this YouTube clip.

The whole thing seems rather improbable to me, to be honest. How many people with chronic lid margin disease (that probably describes a lot of us here) have clear freely running meibum that just needs the orifice punctured? Seems to me like poor meibum production and/or poor consistency meibum are the problems most of us have. For those that have hardened caps which don't respond to warm compresses or gentle at-home lid massage, they can typically be expressed by an ophthalmologist with a 'paddle'. And if the glands are atrophied... that's yet another ballgame....

But, I'll ask around and see what I can find out.

[GILWITEYE]

I'm Paul Gilwit, MD, a dry eye specialist practicing in Fort Lauderdale Florida. I have patented a new meibomian gland expression instrument which gently opens meibomian glands without the use of sharp implements. I have found that with multiple expression procedures, which usually take about 5 minutes, along with lid hygiene and holistic nutritional supplimentation that meibomian gland function can be remarkably and permanently improved. The quality of the gland secretions also improve over time. Meibomian gland secretions hold the tear film together for a much longer time. This dramatically improves over 80-90 % of dry eye sufferers. The benifits of this procedure is felt immediately by the patient. Many of my patients have experienced over 4 months of dry eye symptom relief after the very first expression. In the past dry eye was thought to be mostly caused by decreased tear production but now I've shown that the vast majority of cases are really tear dysfunction stemming mostly from meibomian gland disease. Call my office for any further explanation or assistance 954-772-9911

[Rebecca Petris]

Thank you for your post, Dr. Gilwit. It's always so refreshing to hear this from an MD. Many of our members here have had uncontrolled meibomian gland disease for a long time that was never diagnosed or treated till after visiting several doctors - so MG treatment & maintenance is a constantly recurring topic around here.

As many of our members who have spoken with me know, my 'acid test' for determining whether their doc is meibomian gland savvy enough to stick with long-term is, "Doctor, would you please express my meibomian glands?"