Safety and effectiveness of Bian-stone and moxibustion in treatment of meibomian gland dysfunction.

AIM: To propose a novel Bian-stone and moxibustion (BSM) therapy for meibomian gland dysfunction (MGD) treatment, and to evaluate its clinical efficacy and safety based on objective ocular surface parameters. METHODS: A total of 140 patients with MGD were enrolled in this randomized controlled study and equally allocated (1:1 ratio) into the BSM group and the intense pulsed light (IPL) group. Patients in the BSM group received 30-minute BSM treatment every other day. Subjects in the IPL group completed four independent treatment sessions. The evaluated outcomes included the Ocular Surface Disease Index (OSDI), eyelid margin morphology, meibomian gland (MG) morphology and function, tear film breakup time (TBUT), ocular surface staining (OSS) score, Schirmer's test (ST), and tear meniscus height (TMH). All assessments were performed at baseline, as well as at 1- and 3-month follow-ups after treatment. RESULTS: The BSM group consisted of 24 males and 47 females with a mean age of 59.04±16.50y, while the IPL group included 27 males and 42 females with a mean age of 60.39±15.90y. No significant differences in age, sex distribution, and clinical history were observed between the two groups. At 1 and 3mo post-treatment, the BSM group exhibited significant improvements in OSDI scores, eyelid margin hyperemia and neovascularization, MG expression, secretion status and gland loss, conjunctival hyperemia, and TBUT. Notably, the BSM group achieved superior improvements in OSDI scores and eyelid neovascularization compared with the IPL group at the 3-month follow-up. Additionally, significant reductions in eyelid margin edema and irregularity were only observed in the BSM group at 3mo after intervention. CONCLUSION: BSM therapy can effectively relieve clinical symptoms and restore tear film homeostasis in patients with MGD, serving as a promising and viable therapeutic approach for MGD management.