[Acaricidal therapy in chronic demodex blepharitis and meibomian gland dysfunctions]

The study comparatively evaluates the effectiveness of various approaches to acaricidal treatment in patients with chronic demodex blepharitis and meibomian gland dysfunctions.

The study included 40 patients with chronic blepharitis (CB) of demodicosis etiology in conditions of meibomian gland dysfunction (MGD) and dry eye (DE). The 1^st group of patients (20 people) received acaricidal treatment as part of therapeutic eyelid hygiene (TEH; 2 times a day) involving the use of «Blefarogel ochishchenie», «Blefarolosion», «Blefarogel forte» (contains sulfur and metronidazole). Acaricidal treatment in the patients of the 2^nd group involved applications of a product containing metronidazole (2 times a day) without TEH. Control points: 1) at inclusion in the study; 2) after a course of therapy (45 days). Evaluation included: patient acarograms, symptoms and signs of CB (points); OSDI; tear film break-up time (TBUT, sec), severity of meibomian gland dysfunction (S-MGD, points). Statistical analysis: calculation of M±SD, Mann-Whitney, and Wilcoxon tests.

Acaricidal treatment was effective in both groups (reduction in demodex population, which was more pronounced in the 1^st group). Symptoms and signs of CB were significantly less pronounced in the patients of the 1^st group after therapy. The patients of the 1^st group showed a significant decrease in S-MGD, OSDI and an increase in TBUT, the 2^nd group - a significant decrease in OSDI and an increase in TBUT at the second control point. The positive OSDI and TBUT trends were significantly more pronounced in the 1^st group.

Acaricidal treatment as part of TEH showed a significantly more pronounced reduction in demodex population, relief of CB symptoms and sign, OSDI decrease and TBUT increase, compared to the 2^nd group. Apparently, this was associated with combined acaricidal effect and significant S-MGD decrease in the patients of the 1^st group.