Hypochlorous Acid Can Be the Novel Option for the Meibomian Gland Dysfunction Dry Eye through Ultrasonic Atomization

BACKGROUND: Dry eye is a multifactor disease which needs comprehensive treatments to keep the homeostasis of ocular surface. OBJECTIVE: To explore the effect of hypochlorous acid on the meibomian gland dysfunction dry eye through ultrasonic atomization. METHODS: We set this study of 0.01% HOCL and 0.1% hyaluronate by ultrasonic atomization. All the data was recorded at the 1(st), 15(th), 30(th), and 55(th) days. The patients' complains, the meibum analysis, conjunctive congestion, corneal staining, Schirmer's I test, and NIBUT were recorded by K5M, the MMP-9, and IL-2 of tear by inflammation kit; the Demodex was recorded by microscopy. RESULTS: 53 patients have joined this study. There is no statistic difference between them on OSDI (day 15: p = 0.061, 30: p = 0.055, 55: p = 0.052); results show the 10.57 ± 0.13 and 12.54 ± 0.17 reduction on OSDI; the differences of both treatments are significant ((∗∗)p < 0.01). Increased Schirmer's and TBUT are 3.27 ± 0.10 and 6.29 ± 0.10 ((∗∗)p < 0.01) or 7.32 ± 1.72 s and 9.22 ± 1.41 s ((∗)p < 0.05); the decreased conjunctive and corneal staining are 0.23 ± 0.07 and 0.45 ± 0.06 ((∗∗)p < 0.01) or 0.42 ± 0.03 and 0.37 ± 0.02 ((∗)p < 0.05) at both groups. The differences of MMP-9 and IL-2 negative rate are significant (Z = 0.896, (∗∗)p = 0.002 < 0.01; Z = 0.659, (∗∗)p = 0.001 < 0.01); the number of Demodex mites at first is 10 or 11, while the last is 2 or 6 (Z = −4.642, (∗∗)p < 0.01; Z = 2.742, p > 0.05). The Demodex count between them is significant (Z = −2.310, (∗)p = 0.032 < 0.05). The survival times (ST) of each stage at the HOCL are 110.75 (108.50 ± 24.50), 95.50 (90.25 ± 14.50), and 75.25 (73.48 ± 8.50) min which are shorter than those of control which are 155.50 (160.10 ± 21.50), 130.25 (128.25 ± 16.50), and 105.75 (102.50 ± 14.50) min ((∗∗)p < 0.01). The Demodex eradication rate of HOCL is statistic significant ((∗)p15(th) vs. 1(st)day = 0.028 < 0.05; (∗∗)p30(th) vs. 1(st)day = 0.002 < 0.01; (∗∗)p55(th) vs. 1(st)day = 0.0018 < 0.01). CONCLUSIONS: 0.01% HOCL improves the Demodex eradication by shortening the survival time; the HOCL acts on the ocular surface by reducing the inflammation. The ultrasonic atomization helps for the drug usage.