Meibomian Gland Dysfunction Clinical Trial
Official title:
Antimicrobial and Clinical Efficacy of Cliradex® as Compared With I-Lid'n Lash® Hygiene in Treating Blepharitis: A Randomized, Outcomes-Assessor Masked, Clinical Trial
Previous studies have shown the clinical and antimicrobial efficacy of eyelid hygiene with
tea tree oil (TTO) in resolving chronic blepharitis. Cliradex® is a novel over-the-counter
eyelid wipe which contains the most active ingredient of TTO. The present study is a
single-centre, randomized, trial comparing Cliradex® eyelid hygiene and I-Lid 'n Lash®
Hygiene, another over-the-counter eyelid wipe, without any medicinal ingredients, in treating
chronic blepharitis. The Primary Outcome Measure will be the difference in change in the
number of CFU's after 2 weeks treatment, between the groups. The Secondary Outcome Measure
will be the difference in change in objective clinical signs and symptoms by performing a
vision check, a questionnaire, and visual grading, of each participants' blepharitis after 2
weeks treatment, between the groups. The Tertiary Outcome Measures will be the difference in
change in microbial CFUs and clinical signs and symptoms between the groups at the 4 and 6
week point, (2 and 4 weeks after discontinuing treatment), to evaluate if the treatment will
produce a lasting effect.
Participants will be randomized into one of the treatment arms. They will use the appropriate
treatment for two weeks. They will then be re-assessed. They will discontinue treatment at
this time, and four weeks later, will be assessed one last time, to see if the temporary
treatment provides a lasting effect. A sub-group of ten patients per group will also be
randomized to an extra visit. This group will be assessed after two weeks of having stopped
the wipes. The same testing and procedures will be performed at this appointment.
Previous studies have shown the clinical and antimicrobial efficacy of eyelid hygiene with
tea tree oil (TTO) in resolving chronic blepharitis. This randomized, outcomes-assessor
masked, clinical trial aims to determine the efficacy of Cliradex®, which contains the most
active ingredient of (TTO), as compared with I-Lid 'n Lash® Hygiene, in treating chronic
blepharitis
Blepharitis is a family of inflammatory disease processes of the eyelid. It can be divided
anatomically into anterior and posterior blepharitis. Anterior blepharitis refers to
inflammation mainly centered around the eyelashes and follicles, while the posterior variant
involves the meibomian gland orifices. Anterior blepharitis usually is subdivided further
into staphylococcal and seborrheic variants. Frequently, a considerable overlap exists in
these processes in individual patients. Blepharitis often is associated with systemic
diseases, such as rosacea and seborrheic dermatitis, as well as ocular diseases, such as dry
eye syndromes, chalazion, trichiasis, conjunctivitis, and keratitis.1-3
The pathophysiology of blepharitis involves bacterial colonization of the eyelids. This
results in direct microbial invasion of tissues, immune system-mediated damage, or damage
caused by the production of bacterial toxins, waste products, and enzymes. Colonization of
the lid margin is in-creased in the presence of seborrheic dermatitis or meibomian gland
dysfunction.1-3
Blepharitis can be difficult to manage because it is often chronic or tends to recur. Despite
the cause, eyelid hygiene is the cornerstone of treatment for most cases of blepharitis. This
includes the use of commercially available over-the-counter lid cleansing wipes. Previous
studies have shown the clinical and microbial efficacy of lid scrubs with tea tree oil (TTO)
in resolving chronic blepharitis; however, lid scrubs based on TTO are not convenient for
self-administration and cause irritation in some patients.4-11
Cliradex® (Bio-Tissue, Miami, FL) is a commercially available cosmetic pad containing the
most active ingredient of TTO, which also exerts potent anti-microbial effects which may
eliminate the need for systemic and/or topical antibiotic therapy for blepharitis.
In this trial, the investigators propose to conduct a randomized, outcomes assessor masked,
clinical trial to determine the clinical and antimicrobial efficacy of Cliradex® and I-Lid 'n
Lash® Hygiene, in improving the signs and symptoms of blepharitis, as well as decreasing the
microbial flora in these patients.
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