Chelnis James G, Chelnis Alexandra
Manhattan Face and Eye, New York, NY, USA.
New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA.
Clin Ophthalmol. 2025 Mar 26;19:1057-1071. doi: 10.2147/OPTH.S513989. eCollection 2025.
To investigate whether Dynamic Muscle Stimulation technology (DMSt) in the peri-orbital area improves blinking quality in subjects with lower lid laxity and dry eye disease (DED) due to Meibomian Gland Dysfunction (MGD).
Eligible subjects had lower lid laxity and DED due to MGD. Treatment consisted of DMSt administered 4 times at 1-week intervals. Outcome measures were tested before each treatment and at the follow-up (FU) 4 weeks after the final treatment. The main hypothesis was a decrease in the proportion of subjects with lower lid laxity, defined as abnormal lower lid distraction test (LLDT) or abnormal snap-back test (SBT). Outcomes related to DED comprised the modified meibomian gland score (mMGS), tear breakup time (TBUT), and symptoms of DED (OSDI). Other outcomes included the Margin to Reflex Distance 1 and 2 (MRD1 and MRD2), estimation of blink rate, blink quality, and eyelid appearance.
30 subjects completed FU. LLDT decreased from 11.1 (SD 2.2) mm to 5.3 (SD 1.3) mm (P<0.0001). The proportion of subjects with normal LLDT and SBT increased from 3% to 80% and from 30% to 93%, respectively (p<0.0001). Lower lid laxity decreased from 100% at BL to 23% at FU (p<0.0001). MRD2 gradually decreased from 5.5 (SD 0.9) mm at BL to 5.0 (SD 0.4) mm at FU (P<0.001). TBUT, mMGS, and OSDI changed by +286%, -78%, and -53%, respectively (P<0.0001). The proportion of subjects with normal eyelid appearance, blink quality, blink rate and eyelid closure increased from 0 to 63% (p<0.0001), 0 to 73% (p<0.0001), 36% to 93% (p<0.0001) and 73% to 100% (p<0.01), respectively. No adverse events occurred.
In DED patients, DMSt in the peri-orbital area decreases lower lid laxity and improves blinking quality. These, in turn, may be useful for managing signs and symptoms of DED due to MGD.
探讨眶周区域的动态肌肉刺激技术（DMSt）是否能改善因睑板腺功能障碍（MGD）导致下睑松弛和干眼疾病（DED）患者的眨眼质量。
符合条件的患者因MGD导致下睑松弛和DED。治疗包括每隔1周进行4次DMSt治疗。在每次治疗前以及最后一次治疗后4周的随访（FU）时进行结果测量。主要假设是下睑松弛患者比例降低，下睑松弛定义为下睑牵拉试验（LLDT）异常或弹回试验（SBT）异常。与DED相关的结果包括改良睑板腺评分（mMGS）、泪膜破裂时间（TBUT）和DED症状（OSDI）。其他结果包括边缘至反射距离1和2（MRD1和MRD2）、眨眼频率估计、眨眼质量和眼睑外观。
30名患者完成随访。LLDT从11.1（标准差2.2）mm降至5.3（标准差1.3）mm（P<0.0001）。LLDT和SBT正常的患者比例分别从3%增至80%和从30%增至93%（p<0.0001）。下睑松弛从基线时的100%降至随访时的23%（p<0.0001）。MRD2从基线时的5.5（标准差0.9）mm逐渐降至随访时的5.0（标准差0.4）mm（P<0.001）。TBUT、mMGS和OSDI分别变化了+286%、-78%和-53%（P<0.0001）。眼睑外观、眨眼质量、眨眼频率和眼睑闭合正常的患者比例分别从0增至63%（p<0.0001）、0增至73%（p<0.0001）、36%增至93%（p<0.0001）和73%增至100%（p<0.01）。未发生不良事件。
在DED患者中，眶周区域的DMSt可降低下睑松弛并改善眨眼质量。这些反过来可能有助于管理因MGD导致的DED的体征和症状。
