The inclusion criteria for MGD based on DEWS II: OSDI score > 12.5 points, FBUT < 10 s; the presence of lid margin abnormalities, orifice abnormalities, and meibum abnormalities 1 (link), 10 (link). These MGD patients aged above 18 years old, who voluntarily participated in the experiment. Subjects with certain ocular diseases (acute ocular inflammation, obvious scar or keratinization in palpebral margin) or receiving physiotherapy for blepharitis (intense pulsed light, baby shampoo, and demodex blepharitis treatments) in the last 3 months may confound the study results; thus, they were excluded from the study. Subjects were also excluded if they had a related ocular surgery, including cataract surgery, trichiasis surgery, lachrymal duct obstruction, or refractive surgery in the past 3 months. After the procedure and potential consequences of the study were explained elaborately, informed consent was obtained from all subjects before the experiment.
At every follow-up, visual acuity, intraocular pressure and anterior segment were observed so as to ensure the safety of treatment. Subsequently, all participants received ocular surface examination including OSDI, meibomian gland expressibility (MGE), meibomian gland quality (MQ), lid margin, meibograde, fluorescein tear film break-up time (FBUT), non-invasive tear break-up time (NIKBUT), corneal fluorescein staining (CFS), Schirmer I test (SIT), tear meniscus height (TMH), lipid layer thickness (LLT) and incomplete blink rate (%).