Evaluating the efficacy and feasibility of manual digital meibomian gland compression in meibomian gland dysfunction

To evaluate the therapeutic efficacy and clinical feasibility of manual digital meibomian gland compression compared to instrument-assisted mechanical compression in patients with meibomian gland dysfunction (MGD).

Medical records of 70 MGD patients treated between January and December 2022 were retrospectively analyzed. Participants were divided into manual (n = 35) and mechanical compression groups (n = 35). Primary outcomes included Ocular Surface Disease Index (OSDI) scores and ocular surface parameters at 2-week follow-up (14 ± 2 days), and 8-week follow-up (56 ± 2 days). Secondary outcomes assessed manipulation pain intensity (Visual Analogue Scale, VAS), treatment duration, and learning curve length.

Both groups showed significant improvements in OSDI scores, gland plugging, Schirmer I test, and non-invasive break-up time (NIBUT) at both follow-ups (all P < 0.05). The manual group demonstrated earlier meibum quality improvements (2-week follow-up and 8-week follow-up, P < 0.05) compared to mechanical group's 8-week follow-up improvement (P = 0.01), along with superior lid margin regularity at 8-week follow-up (P = 0.04). Significant intergroup differences favored manual compression in gland plugging (P = 0.02), meibum quality (P = 0.03), and NIBUT (P < 0.001) at 8-week follow-up. Manual compression consistently yielded lower pain scores (all P < 0.001) and required fewer training cases (13 vs. 20).

Manual digital compression offers effective MGD management with enhanced patient comfort and faster clinical proficiency compared to mechanical methods. Its demonstrated therapeutic advantages support broader clinical implementation.