Meibomian Gland Recanalization
Among Dr. Gulani’s proprietary m.o.i.s.t.® therapy techniques Meibomian Gland recanalization addresses the lipid (oil) layer of your tear film. Meibomian (“my-boh-mee-an”) glands are 20 – 40 toothpaste tube (slightly crooked though) shaped glands, lined along eye lashes in our eye lids which secrete the oil layer of our tear film to prevent evaporation of our tears too quickly by creating surface tension (making a film of water stay vertical despite gravity).
Blockage, disease or inflammation of these glands results in Meibomian Gland Dysfunction (MGD). You can imagine then that a faulty oil layer can allow our tears to evaporate quickly and cause dry eyes (Evaporative kind of dry eye) and in many cases is associated with lid inflammation (Blepharitis).
Most common causes of MGD include, repeated or incorrectly managed lid inflammations including allergies, gender as in more prevalent in females, advancing age, ethnic background as in Asians have a higher propensity. Wearing eye makeup is another contributing cause of MGD. Eyeliner and other makeup can clog the openings of meibomian glands especially if you don’t thoroughly clean your eyelids and remove all traces of eye makeup before sleep. Wearing contact lenses for especially long durations also is a risk factor. Medical situations can also increase the chances of this infliction and history of arthritis, Sjogrens, Thyroid dysfunction, diabetes etc are important and need control for overall success.
With 3 decades of experience in working with dry eye patients from around the world, Dr. Gulani’s clinical acumen along with cutting edge diagnostic technologies including one of the first Oculus Keratographs in the country can detect all levels of dry eyes from quantitative to qualitative whereby he then designs an individual plan of attack for that dry eye patient. With over 3 Decades of experience Dr. Gulani uses his personally designed instruments to treat Meibomian Gland Dysfunction with:
- One-Step
- Single probe
- Multiple probes
- Staged
- Combination with other treatments
Dr. Gulani has been using Meibomian Gland Recanalization (MGR), as a modified meibomian gland probing (MGP) wherein differential probing performed to the endpoint of recanalization as evidenced by release of trapped meibum and insertion of the marked probe. This technique has successfully treated MGD based dry eyes during m.o.i.s.t.® therapy to the point of even converting them into candidates for laser vision and premium cataract surgery.
Besides an array of technologies like LipiView, LipiFlow, iLux, Tearcare, Blephex and IPL to treat dry eyes, Dr. Gulani’s personal experience in using customized, differential Meibomian Gland recanalization techniques done in-office in less than 10 minutes with a sequential non-cutting probe, and proprietary numbing gel (no painful injections) made in a pharmacy in California has resulted in near 100% success.
This followed by an individually time-planned warm compression of the eyelids and medication protocol of eye drops results in melting and expressing the thickened oil and also changing it chemically to the more user friendly version. No patient has had to undergo repeat MGR treatment because of the role of conscious hygiene and warm compresses that maintains the viability of the meibomian glands long term.
