Schjerven Magno Morten, Olafsson Jonatan, Beining Marie, Moschowits Emily, Lagali Neil, Wolffsohn James S, Craig Jennifer P, Vehof Jelle, Dartt Darlene A, Utheim Tor P
Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway; Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Cont Lens Anterior Eye. 2023 Apr;46(2):101775. doi: 10.1016/j.clae.2022.101775. Epub 2022 Oct 28.
Meibomian gland dysfunction (MGD) reduces quality-of-life and hinders work productivity of millions of patients, with high direct and indirect societal costs. Thickened meibum obstructs the glands and disrupts ocular surface health. Heating the eyelids to soften and express meibum from the glands can be beneficial. The most accessible method for eyelid warming uses heated, wet towels. However, the efficacy of this treatment is reliant on the methodology, and evidence-based best-practice recommendations are needed.
To evaluate the literature on hot towels in MGD treatment and recommend a best-practice protocol for future research and patient treatment.
Studies were identified through PubMed on the May 28, 2021, with the search terms: (warm* OR heat* OR thermal* OR towel OR wet towel) AND (meibomian OR MGD OR eyelid OR "dry eye" OR DED). All relevant original articles with English full-text were included.
The search yielded 903 results, of which 22 met the inclusion criteria. Across studies, hot towels were found to be effective at reducing ocular symptoms. However, without reheating, the temperature quickly fell below the therapeutic range, which was deemed to be between 40 °C and 47 °C. Towels heated to around 45 °C and reheated every-two minutes were most effective at increasing eyelid temperature, comparable or better than several commercially available eyelid warming devices. No adverse effects were reported in the studies.
Hot towel treatment effectively warms the eyelids and reduces ocular symptoms, but must be standardized, and towels reheated to achieve maximum benefit. Future research should assess patient satisfaction with different hot towel treatment methods that reheat or replace the towel at least every-two minutes, to establish which methods yield the greatest compliance. Guidelines or clinical recommendations that do not mention the need for regular reheating during hot towel compress treatment should be updated to include this.
睑板腺功能障碍（MGD）降低了数百万患者的生活质量，阻碍了他们的工作效率，带来了高昂的直接和间接社会成本。睑脂增厚会阻塞腺体并破坏眼表健康。加热眼睑以软化并排出腺体中的睑脂可能有益。最容易实现的眼睑加热方法是使用加热的湿毛巾。然而，这种治疗方法的疗效取决于具体操作方式，因此需要基于证据的最佳实践建议。
评估关于热毛巾治疗MGD的文献，并为未来的研究和患者治疗推荐最佳实践方案。
于2021年5月28日通过PubMed进行检索，检索词为：（warm* 或 heat* 或 thermal* 或 towel 或 wet towel）以及（meibomian 或 MGD 或 eyelid 或 “dry eye” 或 DED）。纳入所有具有英文全文的相关原创文章。
检索结果共903条，其中22条符合纳入标准。在各项研究中，发现热毛巾在减轻眼部症状方面有效。然而，如果不重新加热，温度会迅速降至治疗范围以下，该治疗范围被认为是40°C至47°C之间。加热至约45°C并每两分钟重新加热一次的毛巾在提高眼睑温度方面最有效，与几种市售的眼睑加热设备相当或更好。研究中未报告不良反应。
热毛巾治疗能有效加热眼睑并减轻眼部症状，但必须进行标准化，且毛巾需重新加热以实现最大益处。未来的研究应评估患者对不同热毛巾治疗方法的满意度，这些方法应至少每两分钟重新加热或更换毛巾，以确定哪种方法的依从性最高。未提及热毛巾热敷治疗期间需要定期重新加热的指南或临床建议应进行更新以纳入这一内容。
