Abstract: Objective The objective of this study is to compare the efficacy of a novel roller-type meibomian gland massage forceps with traditional instruments(round-tip forceps and cotton-tipped applicator)in managing meibomian gland dysfunction(MGD). The study will evaluate improvements in ocular surface parameters and meibomian gland function. Methods In this randomised controlled trial, 84 patients(168 eyes)diagnosed with MGD were enrolled between April 2023 and April 2024. Participants were randomly allocated to one of three intervention groups: cotton-tipped applicator(n=28), round-tip forceps (n=28), or novel massage forceps(n=28). The study protocol stipulated that all groups receive a standardized meibomian gland massage protocol once per week for a period of four weeks. The primary outcomes encompassed the Ocular Surface Disease Index(OSDI)score, the corneal fluorescein staining(FL)score, the meibomian gland expressibility score, and the meibomian secretion quality score. These were assessed at baseline and at weeks 1, 2, and 4 post-intervention. Results A subsequent analysis of baseline demographic data and all outcome measures(OSDI, FL, meibomian gland expressibility, and secretion quality scores)revealed no statistically significant differences among the three groups, indicating consistent baseline characteristics and comparability(P>0.05). Subsequent to the second week following the intervention, all three groups exhibited significant enhancements in all outcome measures in comparison with baseline, with the extent of the enhancements increasing over time(P<0.05). Inter-group comparisons revealed that the novel roller-type meibomian gland massage forceps was significantly superior to the traditional cotton-tipped applicator in alleviating subjective symptoms(OSDI), promoting meibum expression, and improving secretion quality(P<0.05), and was either superior or equivalent to round-tip forceps across multiple indicators. With regard to the enhancement of FL scores, the novel forceps and round-tip forceps exhibited comparable efficacy(week 2: P=0.206; week 4: P=0.397), yet both were found to be significantly superior to the cotton-tipped applicator group(P<0.05). Conclusion The novel roller-type meibomian gland massage forceps have been demonstrated to be a more efficacious intervention than the traditional cotton-tipped applicator method for alleviating symptoms, restoring tear film stability, and improving meibomian gland function in patients diagnosed with MGD. Its efficacy is comparable to or superior to that of conventional round-tip forceps, suggesting that it is a promising and potentially more efficient tool for clinical practice.

Key words: Meibomian gland dysfunction, Dry eye, Meibomian gland massage