Lid Warming Devices Improve Meibomian Gland Health Metrics

Cornea showing dry eye.
The improvement in signs and symptoms persisted for 6 months after treatment, according to a report.

Thermoelectric warming therapy devices can improve signs and symptoms of meibomian gland dysfunction (MGD), regardless of underlying ocular conditions, according to study findings published in the American Journal of Ophthalmology. The improvement persisted for 6 months following treatment, the report shows.  

Researchers retrospectively evaluated a consecutive case series of 203 eyes from 102 patients (mean age: 65.8±15.7 years, age range: 18 to 91 years, 79.3% women) with dry eye disease (DED) treated with MiBoFlo. Before and 6 months after MiBoFlo at a dry eye center, the team assessed the Ocular Surface Disease Index (OSDI) and the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaires, best-corrected visual acuity (BCVA), tear osmolarity, tear film breakup time (TBUT), corneal and conjunctival staining, meibography, number of glands expressing liquid and quality of the meibum improvement. The study excluded patients with active ocular inflammation.  

At month 6, both OSDI and SPEED revealed lower dry eye symptoms by approximately 35% (P <.001). The researchers observed a significant improvement in lissamine green conjunctival staining, corneal fluorescein staining, TBUT, osmolarity, and secreting meibomian glands and meibum quality. They also observed improvement across all domains of the questionnaires and across all baseline parameters. The team notes that eyes with blepharitis and autoimmune disease had less improvement than average. No complications or adverse events were reported.   

“MiBoFlo treatments produced clinical and statistically significant improvements in the signs and symptoms of MGD irrespective of underlying ocular conditions,” according to the report. “This improvement was sustained for the six-month period of observation after initiating the treatment.” 

This study may have been limited by not contemporaneously comparing MiBoFlo to other dry eye treatments. 

The MiBoFlo is an FDA class II device and this is the first large study to evaluate its efficacy, according to the researchers.  


Gomez ML, Afshari NA, Gonzalez DD, Cheng L. Effect of thermoelectric warming therapy for the treatment of meibomian gland dysfunction. Am J Ophthalmol. Published online June 24, 2022. doi:10.1016/j.ajo.2022.06.013