In this installment of Interventional Mindset, Drs. Marc Bloomenstein and Hovanesian discuss using the TearCare System as an effective treatment for addressing meibomian gland dysfunction (MGD).
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Manual expression of meibomian glands is beneficial for many patients
The OLYMPIA study compared the effectiveness of LipiFlow and the TearCare System in treating MGD. The results showed that both treatments significantly enhanced meibomian gland expression, tear break-up time (TBUT), meibomian gland secretion score (MGSS), and patient symptoms. Importantly, TearCare appeared to be more advantageous for patients with more severe MGD.1
What is the TearCare system?
The TearCare System employs Thermal-Activated Restorative Gland Expression Therapy (TARGET) technology.2 This system uses thermal activation to soften gland obstructions and gland expression to restore gland function.3
What did the SAHARA study show?
Phase 1 of the SAHARA study was a 6-month randomized controlled trial (RCT) comparing Restasis (BID) with TearCare. The primary endpoints were TBUT and the Ocular Surface Disease Index (OSDI) questionnaire scores.
Patients in the TearCare group received two treatments (at baseline and at 5 months). The study reported significant improvements in TBUT, MGSS scores, and both objective signs and subjective symptoms.4
In phase 2, patients transitioning from Restasis to TearCare experienced additional improvements without requiring daily patient adherence.5 Long-term data suggest that two TearCare treatments within the first 5 months can provide symptom relief for up to 2 years.6
To read more about the SAHARA study, check out the Glance story: 24-month data from SAHARA RCT supports TearCare durability for DED!
What does this mean for patients?
Data from the SAHARA study show that these treatment benefits lasted for most patients, and performing a procedure while the patient is seated in the chair ensures complete treatment adherence.6
Optimizing the ocular surface
Drs. Hovanesian and Bloomenstein discussed that optimizing the ocular surface is an important step for various patients, including contact lens wearers, those with fluctuating vision, and individuals preparing for refractive surgery. This in-office treatment offers significant benefits, whether used as a pre-surgical measure or for managing existing ocular conditions.
TearCare System: Standard of care?
The TFOS DEWS III recognizes TearCare as an effective, device-driven technology for external eyelid heating and in-office treatment, enhancing patient outcomes.3 Additionally, strong clinical data supporting dry eye treatments is encouraging many insurance plans to cover these procedures.
Patient selection: Screen all ages
Dr. Bloomenstein discussed that dry eye is increasingly affecting younger individuals. This trend is linked to greater screen use, as these users blink less frequently, which can lead to an evaporative disease state. Dr. Hovanesian cited a 2018 study by Gupta et al., which found that 42% of pediatric patients, even when asymptomatic, showed meibomian gland atrophy.7
For many patients, treatment is generally more successful in the early stages of dry eye. Localized heat therapy with manual expression, such as TearCare, is suggested as a more effective alternative to long-term medication for young children.
