Pellevé™ vs Lipiflow™ MGD-Related Dry Eye Treatment Study: The ThermaLid™ Procedure A Pilot Study Comparing the Efficacy of the Pellevé System to LipiFlow for the Treatment of Dry Eye due to Meibomian Gland Dysfunction

Main Article Content

Edward Hall Jaccoma
Craig Litherland
Andrew Jaccoma
Aseef Ahmed


Objective: To assess the safety and efficacy of the Pellevé Wrinkle Treatment System as compared to LipiFlow, for treatment of dry eye syndrome due to meibomian gland dysfunction (MGD).

Materials and Methods: In this split face, randomized study, ten patients who met specific criteria for inclusion were followed after treatment with the Pellevé Wrinkle Reduction System (what the authors have dubbed the "thermaLid Procedure") and a standard LipiFlow procedure performed the same day, with 1 and 3 months follow-up. Pre- and post- treatment MGD was assessed using a variety of subjective and objective measurements.  

Results: The function of the meibomian glands improved significantly from baseline to 3 months for both thermaLid and Lipiflow treated eyes, with no significant difference between them, as measured by MGE grading, wax plug scoring, Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index (OSDI) scoring. A significant change in conjunctival staining was found after both treatments at the 1-month time point but not the 3-month time point. thermaLid but not Lipiflow treatment, significantly decreased MARX line measurements at 3-months. Lipiview, Non-Invasive Tear Breakup Time (NITBUT), corneal surface staining, Tear Osmolarity, and anesthetic Schirmer's testing did not show statistically significant improvement, nor differences between treatment modalities.

Conclusions: thermaLid treatment of the eyelids appears to show efficacy similar to Lipiflow treatment in reducing symptoms, reducing wax plugging and improving the number of functioning MGs as well as reducing conjunctival staining in MGD related dry eye disease.


Download data is not yet available.

Article Details



1. Reddy P, Grad O, Rajagopalan K. The economic burden of dry eye: a conceptual framework and preliminary assessment. Cornea. 2004;23(8):751-61.
2. Lemp MA, Crews LA, Bron AJ, Foulks GN, Sullivan BD. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study. Cornea. 2012;31(5):472-8.
3. Tong L, Chaurasia SS, Mehta JS, Beuerman RW. Screening for meibomian gland disease: its relation to dry eye subtypes and symptoms in a tertiary referral clinic in singapore. Invest Ophthalmol Vis Sci. 2010;51(7):3449-54.
4. Viso E, Rodriguez-Ares MT, Gude F. Prevalence of and associated factors for dry eye in a Spanish adult population (the Salnes Eye Study). Ophthalmic Epidemiol. 2009;16(1):15-21.
5. Stapleton F, Garrett Q, Chan C, Craig JP. Dry eye: A practical approach. Chan C, editor. Berlin, Germany: Springer-Verlag Berlin Heidelberg; 2015.
6. Moss SE, Klein R, Klein BE. Prevalence of and risk factors for dry eye syndrome. Arch Ophthalmol. 2000;118(9):1264-8.
7. 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(8):675-83.
8. Buchholz P, Steeds CS, Stern LS, Wiederkehr DP, Doyle JJ, Katz LM, et al. Utility assessment to measure the impact of dry eye disease. Ocul Surf. 2006;4(3):155-61.
9. Chan C. Dry Eye: A Practical Approach. Chan C, editor. Berlin, Germany: Springer-Verlag Berlin Heidelberg; 2015.
10. Blackie CA, Carlson AN, Korb DR. Treatment for meibomian gland dysfunction and dry eye symptoms with a single-dose vectored thermal pulsation: a review. Curr Opin Ophthalmol. 2015;26(4):306-13.
11. Rusciani A, Curinga G, Menichini G, Alfano C, Rusciani L. Nonsurgical tightening of skin laxity: a new radiofrequency approach. J Drugs Dermatol. 2007;6(4):381-6.
12. Taub AF, Tucker RD, Palange A. Facial tightening with an advanced 4-MHz monopolar radiofrequency device. J Drugs Dermatol. 2012;11(11):1288-94.
13. Stampar M. The Pelleve procedure: an effective method for facial wrinkle reduction and skin tightening. Facial Plast Surg Clin North Am. 2011;19(2):335-45.
14. Javate RM, Cruz RT, Jr., Khan J, Trakos N, Gordon RE. Nonablative 4-MHz dual radiofrequency wand rejuvenation treatment for periorbital rhytides and midface laxity. Ophthal Plast Reconstr Surg. 2011;27(3):180-5.
15. Zelickson BD, Kist D, Bernstein E, Brown DB, Ksenzenko S, Burns J, et al. Histological and ultrastructural evaluation of the effects of a radiofrequency-based nonablative dermal remodeling device: a pilot study. Arch Dermatol. 2004;140(2):204-9.
16. Fitzpatrick R, Geronemus R, Goldberg D, Kaminer M, Kilmer S, Ruiz-Esparza J. Multicenter study of noninvasive radiofrequency for periorbital tissue tightening. Lasers Surg Med. 2003;33(4):232-42.
17. Korb DR, Blackie CA. Meibomian gland diagnostic expressibility: correlation with dry eye symptoms and gland location. Cornea. 2008;27(10):1142-7.
18. Yamaguchi M, Kutsuna M, Uno T, Zheng X, Kodama T, Ohashi Y. Marx line: fluorescein staining line on the inner lid as indicator of meibomian gland function. Am J Ophthalmol. 2006;141(4):669-75.