Skip to main content
Top
Published in: Ophthalmology and Therapy 2/2019

Open Access 01-06-2019 | Xerophthalmia | Brief Report

Efficacy and Safety of Wet Wipes Containing Hy-Ter® Solution Compared with Standard Care for Bilateral Posterior Blepharitis: A Preliminary Randomized Controlled Study

Authors: Valentina De Luca, Adriano Carnevali, Giovanna Carnovale Scalzo, Gabriele Piccoli, Donatella Bruzzichessi, Vincenzo Scorcia

Published in: Ophthalmology and Therapy | Issue 2/2019

Login to get access

Abstract

Introduction

A novel treatment for posterior blepharitis which involves the use of disposable wet wipes imbibed with a solution of terpinen-4-ol and hyaluronic acid (Hy-Ter®) as well as aloe, natural anti-inflammatories and antiseptics (Blephapad Combo; Novelty Technology Care, Milan, Italy) has been proposed. The aim of this study was to compare the efficacy and safety of treatment with Blephapad Combo with standard treatment.

Methods

We conducted 4-week, open-label, randomized controlled study with a closed sequential design at the Magna Graecia University of Catanzaro, Italy in which patients aged > 40 years with symmetrical bilateral posterior blepharitis were enrolled. Each eye represented a single experimental unit. Patients were randomly assigned using a computer-generated randomization list to apply a reusable heated compress to the eyelid of one eye before cleansing the eyelid with the Blephapad Combo wet wipe (Blephapad Combo treatment arm) or to use the standard treatment of applying a wet and warm gauze to the other eye (standard treatment arm), twice daily for 4 weeks. The primary endpoint was the percentage change from baseline to week 4 in meibomian gland dysfunction (MGD) grading scale scores.

Results

Eighteen patients (9 men; 9 women) with a mean (± standard deviation) age of 66.9 ± 9.03 years were included in the study. Compared with the eye receiving the standard treatment, treatment with Blephapad Combo appeared to improve the MGD total score after 4 weeks of treatment (mean change from baseline − 29.9 vs. − 38.5%). The assessment of the investigators was that in 11 patients the eye treated with Blephapad Combo showed greater benefit, in two patients the eye treated with the standard treatment showed greater benefit and in four patients there was no difference between treatments. Blephapad Combo was well tolerated, with no serious adverse events (AEs) reported. Minor ocular AEs were reported in 44.4 and 38.9% of patients in the Blephard Combo and standard treatment arms, respectively.

Conclusions

Treatment with Blephapad Combo was more effective than the standard treatment in ameliorating MGD in patients with posterior blepharitis. Minor ocular AEs events were equally distributed between the two treatments arms.

Trial Registration

ClinicalTrials.gov identifier: NCT03301844.
Literature
1.
go back to reference Mathers WD. Ocular evaporation in meibomian gland dysfunction and dry eye. Ophthalmology. 1993;100:347–51.CrossRef Mathers WD. Ocular evaporation in meibomian gland dysfunction and dry eye. Ophthalmology. 1993;100:347–51.CrossRef
2.
go back to reference Shimazaki J, Sakata M, Tsubota K. Ocular surface changes and discomfort in patients with meibomian gland dysfunction. Arch Ophthalmol. 1995;113:1266–70.CrossRef Shimazaki J, Sakata M, Tsubota K. Ocular surface changes and discomfort in patients with meibomian gland dysfunction. Arch Ophthalmol. 1995;113:1266–70.CrossRef
3.
go back to reference Mathers WD, Shields WJ, Sachdev MS, Petroll WM, Jester JV. Meibomian gland dysfunction in chronic blepharitis. Cornea. 1991;10:277–85.CrossRef Mathers WD, Shields WJ, Sachdev MS, Petroll WM, Jester JV. Meibomian gland dysfunction in chronic blepharitis. Cornea. 1991;10:277–85.CrossRef
4.
go back to reference Liu J, Sheha H, Tseng SC. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol. 2010;10:505–10.CrossRef Liu J, Sheha H, Tseng SC. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol. 2010;10:505–10.CrossRef
6.
go back to reference Duncan K, Jeng BH. Medical management of blepharitis. Curr Opin Ophthalmol. 2015;26:289–94.CrossRef Duncan K, Jeng BH. Medical management of blepharitis. Curr Opin Ophthalmol. 2015;26:289–94.CrossRef
7.
go back to reference Pizarro TP, Filho IJZ, Kaiser FS, Liedtke IS, Cabrini HC, Yanaguihara MM, et al. Chronic blepharitis: review of incidence, prevalence and treatments. Int J Dev Res. 2015;5:5039–43. Pizarro TP, Filho IJZ, Kaiser FS, Liedtke IS, Cabrini HC, Yanaguihara MM, et al. Chronic blepharitis: review of incidence, prevalence and treatments. Int J Dev Res. 2015;5:5039–43.
8.
go back to reference Gao YY, Di Pascuale MA, Elizondo A, Tseng SC. Clinical treatment of ocular demodecosis by lid scrub with tea tree oil. Cornea. 2007;26:136–43.CrossRef Gao YY, Di Pascuale MA, Elizondo A, Tseng SC. Clinical treatment of ocular demodecosis by lid scrub with tea tree oil. Cornea. 2007;26:136–43.CrossRef
9.
go back to reference Hirsch-Hoffmann S, Kaufmann C, Bänninger PB, Thiel MA. Treatment options for demodex blepharitis: patient choice and efficacy. Klin Monbl Augenheilkd. 2015;232:384–7.CrossRef Hirsch-Hoffmann S, Kaufmann C, Bänninger PB, Thiel MA. Treatment options for demodex blepharitis: patient choice and efficacy. Klin Monbl Augenheilkd. 2015;232:384–7.CrossRef
10.
go back to reference Tighe S, Gao YY, Tseng SC. Terpinen-4-ol is the most active ingredient of tea tree oil to kill demodex mites. Transl Vis Sci Technol. 2013;2:2.CrossRef Tighe S, Gao YY, Tseng SC. Terpinen-4-ol is the most active ingredient of tea tree oil to kill demodex mites. Transl Vis Sci Technol. 2013;2:2.CrossRef
11.
go back to reference Arita R, Minoura I, Morishige N, Shirakawa R, Fukuoka S, Asai K, et al. Development of definitive and reliable grading scales for meibomian gland dysfunction. Am J Ophthalmol. 2016;169:125–37.CrossRef Arita R, Minoura I, Morishige N, Shirakawa R, Fukuoka S, Asai K, et al. Development of definitive and reliable grading scales for meibomian gland dysfunction. Am J Ophthalmol. 2016;169:125–37.CrossRef
12.
13.
go back to reference Olson MC, Korb DR, Greiner JV. Increase in tear film lipid layer thickness following treatment with warm compresses in patients with meibomian gland dysfunction. Eye Contact Lens. 2003;29:96–9.CrossRef Olson MC, Korb DR, Greiner JV. Increase in tear film lipid layer thickness following treatment with warm compresses in patients with meibomian gland dysfunction. Eye Contact Lens. 2003;29:96–9.CrossRef
14.
go back to reference Geerling G, Tauber J, Baudouin C, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on management and treatment of meibomian gland dysfunction. Investig Ophthalmol Vis Sci. 2011;52:2050–64.CrossRef Geerling G, Tauber J, Baudouin C, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on management and treatment of meibomian gland dysfunction. Investig Ophthalmol Vis Sci. 2011;52:2050–64.CrossRef
15.
go back to reference Blackie CA, Solomon JD, Greiner JV, Holmes M, Korb DR. Inner eyelid surface temperature as a function of warm compress methodology. Optom Vis Sci. 2008;85:675–83.CrossRef Blackie CA, Solomon JD, Greiner JV, Holmes M, Korb DR. Inner eyelid surface temperature as a function of warm compress methodology. Optom Vis Sci. 2008;85:675–83.CrossRef
16.
go back to reference Sim HS, Petznick A, Barbier S, et al. A randomized, controlled treatment trial of eyelid-warming therapies in meibomian gland dysfunction. Ophthalmol Ther. 2014;3:37–48.CrossRef Sim HS, Petznick A, Barbier S, et al. A randomized, controlled treatment trial of eyelid-warming therapies in meibomian gland dysfunction. Ophthalmol Ther. 2014;3:37–48.CrossRef
17.
go back to reference Borchman D, Foulks GN, Yappert MC, et al. Human meibum lipid conformation and thermodynamic changes with meibomian-gland dysfunction. Investig Ophthalmol Vis Sci. 2011;52:3805–17.CrossRef Borchman D, Foulks GN, Yappert MC, et al. Human meibum lipid conformation and thermodynamic changes with meibomian-gland dysfunction. Investig Ophthalmol Vis Sci. 2011;52:3805–17.CrossRef
18.
go back to reference Despa F, Orgill DP, Neuwalder J, Lee RC. The relative thermal stability of tissue macromolecules and cellular structure in burn injury. Burns. 2005;31:568–77.CrossRef Despa F, Orgill DP, Neuwalder J, Lee RC. The relative thermal stability of tissue macromolecules and cellular structure in burn injury. Burns. 2005;31:568–77.CrossRef
19.
go back to reference Lane SS, DuBiner HB, Epstein RJ, et al. A new system, the LipiFlow, for the treatment of meibomian gland dysfunction. Cornea. 2012;31:396–404.CrossRef Lane SS, DuBiner HB, Epstein RJ, et al. A new system, the LipiFlow, for the treatment of meibomian gland dysfunction. Cornea. 2012;31:396–404.CrossRef
20.
go back to reference Pult H, Riede-Pult BH, Purslow C. A comparison of an eyelid-warming device to traditional compress therapy. Optom Vis Sci. 2012;89:E1035–41.CrossRef Pult H, Riede-Pult BH, Purslow C. A comparison of an eyelid-warming device to traditional compress therapy. Optom Vis Sci. 2012;89:E1035–41.CrossRef
21.
go back to reference Su CW, Tighe S, Sheha H, Cheng AMS, Tseng SCG. Safety and efficacy of 4-terpineol against microorganisms associated with blepharitis and common ocular diseases. BMJ Open Ophthalmol. 2018;3:e000094.CrossRef Su CW, Tighe S, Sheha H, Cheng AMS, Tseng SCG. Safety and efficacy of 4-terpineol against microorganisms associated with blepharitis and common ocular diseases. BMJ Open Ophthalmol. 2018;3:e000094.CrossRef
22.
go back to reference Vecchione A, Celandroni F, Lupetti A, Favuzza E, Mencucci R, Ghelardi E. Antimicrobial activity of a new aloe vera formulation for the hygiene of the periocular area. J Ocul Pharmacol Ther. 2018;34:579–83.CrossRef Vecchione A, Celandroni F, Lupetti A, Favuzza E, Mencucci R, Ghelardi E. Antimicrobial activity of a new aloe vera formulation for the hygiene of the periocular area. J Ocul Pharmacol Ther. 2018;34:579–83.CrossRef
23.
go back to reference Karakurt Y, Zeytun E. Evaluation of the efficacy of tea tree oil on the density of Demodex mites (Acari: Demodicidae) and ocular symptoms in patients with demodectic blepharitis. J Parasitol. 2018;104:473–8.CrossRef Karakurt Y, Zeytun E. Evaluation of the efficacy of tea tree oil on the density of Demodex mites (Acari: Demodicidae) and ocular symptoms in patients with demodectic blepharitis. J Parasitol. 2018;104:473–8.CrossRef
24.
go back to reference Maher TN. The use of tea tree oil in treating blepharitis and meibomian gland dysfunction. Oman J Ophthalmol. 2018;11:11–5.PubMedPubMedCentral Maher TN. The use of tea tree oil in treating blepharitis and meibomian gland dysfunction. Oman J Ophthalmol. 2018;11:11–5.PubMedPubMedCentral
25.
go back to reference Brjesky VV, Maychuk YF, Petrayevsky AV, Nagorsky PG. Use of preservative-free hyaluronic acid (Hylabak®) for a range of patients with dry eye syndrome: experience in Russia. Clin Ophthalmol. 2014;8:1169–77.PubMedPubMedCentral Brjesky VV, Maychuk YF, Petrayevsky AV, Nagorsky PG. Use of preservative-free hyaluronic acid (Hylabak®) for a range of patients with dry eye syndrome: experience in Russia. Clin Ophthalmol. 2014;8:1169–77.PubMedPubMedCentral
26.
go back to reference Fromstein SR, Harthan JS, Patel J, Opitz DL. Demodex blepharitis: clinical perspectives. Clin Optom (Auckl). 2018;10:57–63.CrossRef Fromstein SR, Harthan JS, Patel J, Opitz DL. Demodex blepharitis: clinical perspectives. Clin Optom (Auckl). 2018;10:57–63.CrossRef
27.
go back to reference van Onzenoort HA, Menger FE, Neef C, et al. Participation in a clinical trial enhances adherence and persistence to treatment: a retrospective cohort study. Hypertension. 2011;58:573–8.CrossRef van Onzenoort HA, Menger FE, Neef C, et al. Participation in a clinical trial enhances adherence and persistence to treatment: a retrospective cohort study. Hypertension. 2011;58:573–8.CrossRef
Metadata
Title
Efficacy and Safety of Wet Wipes Containing Hy-Ter® Solution Compared with Standard Care for Bilateral Posterior Blepharitis: A Preliminary Randomized Controlled Study
Authors
Valentina De Luca
Adriano Carnevali
Giovanna Carnovale Scalzo
Gabriele Piccoli
Donatella Bruzzichessi
Vincenzo Scorcia
Publication date
01-06-2019
Publisher
Springer Healthcare
Published in
Ophthalmology and Therapy / Issue 2/2019
Print ISSN: 2193-8245
Electronic ISSN: 2193-6528
DOI
https://doi.org/10.1007/s40123-019-0182-x

Other articles of this Issue 2/2019

Ophthalmology and Therapy 2/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.