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Randomized Controlled Trial
. 2023 Jan 1;42(1):44-51.
doi: 10.1097/ICO.0000000000003046. Epub 2022 Apr 13.

Role of Blepharoexfoliation in Demodex Blepharitis: A Randomized Comparative Study

Hossein Mohammad-Rabei  1 , Amir Arabi  1 , Toktam Shahraki  1 , Zahra Rezaee-Alam  1 , Alireza Baradaran-Rafii  1   2
Affiliations
Randomized Controlled Trial

Role of Blepharoexfoliation in Demodex Blepharitis: A Randomized Comparative Study

Hossein Mohammad-Rabei et al. Cornea. .

Abstract

Purpose: The purpose of this study was to evaluate the safety and efficacy of blepharoexfoliation in the treatment of Demodex blepharitis.

Methods: Patients with microscopically approved Demodex blepharitis were enrolled. Patients in the treatment group were treated once with in-office blepharoexfoliation (BlephEx LLC; Franklin, TN) using tea tree oil 2% shampoo, followed by eyelid scrubs with tea tree oil 2% shampoo twice a day for 8 weeks. Patients in the control group were treated with the same protocol, except for the in-office sham blepharoexfoliation procedure. As the main outcome measurement, the changes in the severity of symptoms [Ocular Surface Disease Index (OSDI) score] were compared. The changes in Demodex count and meibomian gland dysfunction (MGD) severity were compared as the secondary outcome measurements.

Results: Eighty-one patients (36 male and 45 female) were included. The mean age of the patients was 53.56 ± 8.13 years. The mean baseline OSDI score was 33.30 ± 11.80. The mean baseline Demodex count was 4.84 ± 1.49. The Demodex count at the baseline visit was moderately correlated with the baseline OSDI score (R = 0.526, P = 0.011) and baseline MGD severity ( P = 0.02). At the 8-week visit, the OSDI score was 22.62 ± 8.23 and 27.09 ± 9.11 in the blepharoexfoliation and control groups, respectively ( P = 0.016). At the 8-week visit, the Demodex count was 2.6 ± 1.08 and 3.03 ± 1.27 in the treatment and control groups, respectively ( P = 0.025). MGD improved in both groups ( P = 0.84). In the blepharoexfoliation group, the change in the OSDI score was moderately correlated with the baseline OSDI score (R = 0.611, P = 0.01).

Conclusions: One session of blepharoexfoliation, followed by manual eyelid scrubs was more effective than eyelid scrubs alone in reducing patients' symptoms and Demodex count.

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Conflict of interest statement

Conflicts of interest statement: The authors have no funding or conflicts of interest to disclose.

References

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