Maskin probe

Noticed all the buzz lately about the new Maskin probe?

EyeWorld discussed it in a recent article about "aggressive" (i.e. beyond doxy, azasite and classic compress/scrub routines) treatments for meibomian gland dysfunction.

The Maskin Meibomian Gland Intraductal Probe (Rhein Medical), developed by Steven L. Maskin, MD, helps remove obstructions within the duct. Dr. Maskin told Primary Care Optometry News that clinicians can enter the meibomian gland with the probe and provide “dramatic and immediate” relief to patients.

Blockages within the gland may be caused by fibrovascular tissue that grows into the duct with new blood vessel formation as well as an abnormal hyperplastic keratinized ductal epithelium or scarring in or over the orifice, he said.

“What I found when I entered the meibomian gland was that there was frequently some resistance deeper inside, within the duct, which was able to be relieved with mild pressure,” Dr. Maskin said. “When you apply that pressure, you’ll be able to penetrate through that and there will be a ‘pop’ characteristic of a fibrovascular membrane. You can create a patent open duct from orifice to the deeper duct. Patients’ lid tenderness dramatically and immediately improves.”

...But wait, lest you interpret my "beyond doxy, azasite, etc", bear in mind that it's probably in addition, not instead of:

...Marguerite McDonald, MD, shared her protocol with PCON. She first holds lidocaine gel against the lid margin to anesthetize the area where the probe will be inserted. Afterward, she prescribes a combination of topical and sometimes oral medications to treat the disease.

“For patients with moderate to severe meibomian gland disease, I place them on ‘soaks and scrubs’ twice daily, as well as on AzaSite (azithromycin 1%, Inspire), one drop in both eyes twice daily for 2 days followed by one drop daily for at least a month,” she said. “Some severe patients stay on AzaSite indefinitely.

“I ask the patients to rub the drop into the base of their lashes for a few seconds while their lids are gently closed, immediately after instilling the drop,” she continued. “In addition, many patients are placed on oral doxycycline (100 mg) twice daily for a week to 10 days, then 20 mg once daily for a few months, if not indefinitely.”

And of course, on DryEyeTalk it's been a subject of discussion for some months past, as in this thread.