Heat treatment and heat loss reduction for treating meibomian gland dysfunction

• US 8,007,524 B2
• Filed: 01/17/2008
• Issued: 08/30/2011
• Est. Priority Date: 05/15/2006
• Status: Active Grant

• Current Assignee: TearScience Inc. (Johnson & Johnson)
• Original Assignee: TearScience Inc. (Johnson & Johnson)
• Inventors: Jans, John Martin, Grenon, Stephen M., Willis, Timothy R., Korb, Donald R.
• Primary Examiner(s): Gibson; Roy
• Assistant Examiner(s): SMITH, KAITLYN ELIZABETH
• Application Number:
  US12/015,584
• Publication Number:
  US 20080114422A1
• Time in Patent Office: 1,321 Days
• Field of Search: 607/96, 128/898, 424/443
• US Class Current: 607/96
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2018/046 in liquid form
• CPC Class Codes: A61B 2018/048 in gaseous form
• CPC Class Codes: A61F 2007/0004 Eyes or part of the face surrounding the eyes
• CPC Class Codes: A61F 2007/0059 with an open fluid circuit
• CPC Class Codes: A61F 7/007 characterised by electric heating
• CPC Class Codes: A61F 7/12 Devices for heating or cooling internal body cavities
• CPC Class Codes: A61F 9/00772 Apparatus for restoration of tear ducts
• CPC Class Codes: A61H 2015/0014 cylinder-like, i.e. rollers
• CPC Class Codes: A61H 7/00 Devices for suction-kneading massage; Devices for massaging the skin by rubbing or brushing not otherwise provided for electro-medical massage devices applying electric current by contact A61N1/18
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

A method of treating meibomian gland dysfunction. Heat is applied to the tissue proximate the patient'"'"'s meibomian glands to provide conductive heat transfer to the meibomian glands. The application of heat assists in the expression of obstructions or occlusions in the meibomian glands to restore sufficient sebum flow to the lipid layer to treat dry eye. A force may also be applied to the tissue proximate the patient'"'"'s meibomian glands to improve conductive heat transfer and reduce blood flow in the tissue that causes convective heat loss. Thus, the application of force can further increase the temperature level and/or reduce the time to reach desired temperature levels for removing obstructions. Reaching increased temperature levels may improve the melting, loosening, or softening of obstructions or occlusions in the meibomian glands while reducing the amount of time to reached desired temperature levels and/or aid in reducing discomfort to the patient during treatment.

Claims

1. A method of treating meibomian gland dysfunction, comprising:

applying a heat to tissue proximate a patient'"'"'s meibomian gland to a temperature level to melt, loosen, or soften an obstruction located within a meibomian gland channel of a meibomian gland;

maintaining the heat to the tissue proximate the patient'"'"'s meibomian gland; and

applying a compressive force to the tissue proximate the patient'"'"'s meibomian gland, during the maintaining the heat to the tissue proximate the patient'"'"'s meibomian gland to apply a pressure to reduce blood flow in an area of the tissue proximate the patient'"'"'s meibomian gland and reduce convective heat loss from the heat, to express the obstruction located within the meibomian gland channel and from within the meibomian gland channel through a meibomian gland orifice of the meibomian gland.

2. The method of claim 1, wherein applying the heat comprises applying the heat to an inner surface of a patient'"'"'s eyelid.

3. The method of claim 2, further comprising positioning an insulator behind the patient'"'"'s eyelid on an external surface sclera of an eye before the applying of the heat to the tissue proximate the patient'"'"'s meibomian gland.

4. The method of claim 1, wherein applying the heat comprises applying the heat to an outer surface of a patient'"'"'s eyelid.

5. The method of claim 1, wherein applying the compressive force comprises applying the compressive force to an inner surface of a patient'"'"'s eyelid.

6. The method of claim 1, wherein applying the compressive force comprises applying the compressive force to an outer surface of a patient'"'"'s eyelid.

7. The method of claim 1, further comprising maintaining the heat to the tissue proximate the patient'"'"'s meibomian gland for a period of time.

8. The method of claim 1, further comprising maintaining the compressive force to the tissue proximate the patient'"'"'s meibomian gland for a period of time, wherein the heat attains a higher temperature level than would otherwise be attained over the period of time if the compressive force were not maintained.

9. The method of claim 8, wherein the period of time for maintaining the compressive force to the tissue proximate the patient'"'"'s meibomian gland is from approximately 1 to 10 minutes.

10. The method of claim 1, wherein during the maintaining the heat, the temperature level rises to a level that would otherwise not be attained if the compressive force were not applied to the tissue proximate the patient'"'"'s meibomian gland.

11. The method of claim 1, wherein the compressive force is applied at a pressure of at least approximately 120 mm Hg.

12. The method of claim 1, wherein the heat applied to the tissue proximate the patient'"'"'s meibomian gland is in a range of approximately about 43 to about 55 degrees Celsius.

13. The method of claim 1, further comprising removing the heat from the tissue proximate the patient'"'"'s meibomian gland.

14. The method of claim 13, wherein the compressive force is applied to the tissue proximate the patient'"'"'s meibomian gland at time intervals.

15. The method of claim 13, further comprising maintaining the compressive force to the tissue proximate the patient'"'"'s meibomian gland after the heat is removed.

16. The method of claim 1, further comprising expressing the obstruction located within the meibomian gland channel from the meibomian gland channel while in a melted, loosened, or softened state.

17. The method of claim 16, wherein the compressive force is maintained to the tissue proximate the patient'"'"'s meibomian gland during the expressing of the obstruction located within the meibomian gland channel from the meibomian gland channel.

18. The method of claim 16, further comprising removing the compressive force from the tissue proximate the patient'"'"'s meibomian gland, wherein the expressing the obstruction is performed after the removing the compressive force.

19. The method of claim 16, wherein the compressive force is maintained to the tissue proximate the patient'"'"'s meibomian gland until the obstruction located within the meibomian gland channel is expressed from the meibomian gland channel.

20. The method of claim 19, further comprising repeatedly performing the applying and the maintaining the heat to the tissue proximate the patient'"'"'s meibomian gland to express the obstruction located within the meibomian gland channel from the meibomian gland channel while in the melted, loosened, or softened state.

21. The method of claim 1, wherein the compressive force applied to the tissue proximate the patient'"'"'s meibomian gland is comprised of a constant compressive force.

22. The method of claim 1, wherein the compressive force is comprised of a mechanical compressive force applied to the tissue proximate the patient'"'"'s meibomian gland.

23. The method of claim 1, further comprising regulating the heat when applying the heat to the tissue proximate the patient'"'"'s meibomian gland.

24. The method of claim 1, further comprising regulating the compressive force when applying the compressive force to the tissue proximate the patient'"'"'s meibomian gland.

25. The method of claim 1, wherein the compressive force applied to the tissue proximate the patient'"'"'s meibomian gland is comprised from the group consisting of a mechanical compressive force, an electrical force, a pneumatic compressive force, and a manual compressive force.

26. The method of claim 1, wherein the compressive force is applied at a pressure of at least approximately 300 mm Hg.

27. The method of claim 1, wherein the compressive force is applied at a pressure of at least approximately 350 mm Hg.