Effect of Oral Linoleic and γ-Linolenic Acid on Meibomian Gland Dysfunction

Purpose: To assess the effect of oral linoleic and γ-linolenic acid, 2 ω-6 essential fatty acids, on meibomian gland dysfunction (MGD). Methods: Fifty-seven patients with MGD (27 men and 30 women) were randomly divided into 3 groups of 19. Group A received tablets containing linoleic acid (28.5 mg) and γ-linolenic acid (15 mg) once daily. Group B performed eyelid hygiene once daily. Group C received both treatments. Initially and after 60 and 180 days of therapy, all patients completed a self-evaluation questionnaire on ocular surface disorders and underwent slit-lamp examination. The following signs were evaluated: eyelid edema, eyelid margin hyperemia, meibomian secretion appearance, meibomian gland obstruction, foam collection in the tear meniscus, conjunctival hyperemia, conjunctival papillae, and corneal staining. Results: Statistically significant improvement in symptoms occurred in all groups. After 180-day therapy, group A showed significant reduction in secretion turbidity (P = 0.02) and meibomian gland obstruction (P = 0.0001), whereas group B had significant reduction in eyelid edema (P = 0.02), corneal staining (P = 0.01), secretion turbidity (P = 0.01), and meibomian gland obstruction (P = 0.0001). Group C had significant reduction in eyelid edema (P = 0.003), foam collection in the tear meniscus (P = 0.02), corneal staining (P = 0.02), secretion turbidity (P = 0.0001), and meibomian gland obstruction (P = 0.0001). Conclusions: Therapy with linoleic and γ-linolenic acid tablets along with eyelid hygiene improves symptoms and reduces eyelid margin inflammation in MGD more than either ω-6 fatty acids or eyelid hygiene alone.