{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:53:37Z","timestamp":1791914017515,"version":"4.3.4"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011665","name":"Deanship of Scientific Research, King Saud University","doi-asserted-by":"publisher","award":["ORF-2026-854"],"award-info":[{"award-number":["ORF-2026-854"]}],"id":[{"id":"10.13039\/501100011665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dry eye syndrome (DES) is a prevalent multifactorial condition characterized by tear film instability and meibomian gland dysfunction (MGD). Warm compress therapy remains a cornerstone for improving lipid layer function. However, very limited comparative data exist on newer USB-powered devices vs. self-heating masks in Middle Eastern populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This randomized crossover clinical trial compared USB-powered and self-heating masks in 15 participants aged 18\u201340 years with meibomian gland dysfunction (MGD) associated eye (tear break-up time \u226410 s). Each intervention was scheduled for five consecutive days, separated by a two-week washout. The prespecified primary outcome was non-invasive TBUT measured with the OCULUS Keratograph 4M; tear meniscus height (TMH) and symptom scores were secondary outcomes. A two-way ANOVA and Post-hoc Bonferroni tests adjusted for multiple comparisons were used for analysis. The trial was registered at ClinicalTrials.gov (NCT07618169).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All 15 participants contributed data to both intervention phases. Across observed visits, the USB-powered device was associated with higher TBUT (likelihood-ratio \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      (1) = 7.43, p\u2009=\u20090.006) and TMH (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      (1) = 4.49, p\u2009=\u20090.034). Day 5 descriptive means with USB-Powered compress and self-heating mask were 9.53\u2009\u00b1\u20092.18 s versus 7.21\u2009\u00b1\u20092.90 s for TBUT, and 0.200\u2009\u00b1\u20090.020 mm versus 0.188\u2009\u00b1\u20090.016 mm for TMH, respectively. No significant between-device difference was observed in SPEED scores, although mean scores showed a mild improvement, and no adverse events were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>USB-powered warm compresses provided superior outcomes in enhancing tear film stability and volume compared to self-heating masks. Consistent temperature control and reusability make them a promising at-home therapy for patients with MGD. USB-powered devices may be preferred for patients requiring sustained thermal therapy, particularly in arid climates with variable indoor cooling. Further large-scale trials are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      This trial was registered at ClinicalTrials.gov under registration number:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT07618169\" xlink:type=\"simple\">NCT07618169<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0360762","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:31:21Z","timestamp":1791912681000},"page":"e0360762","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["USB-powered vs. self-heating warm compresses for meibomian gland dysfunction: A prospective randomized crossover clinical trial"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2900-2662","authenticated-orcid":true,"given":"Ali M.","family":"Al Saqr","sequence":"first","affiliation":[{"name":"King Saud University","place":["Riyadh, Saudi Arabia"],"department":["Optometry Department, College of Applied Medical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moath Faisal","family":"Alharbi","sequence":"additional","affiliation":[{"name":"King Saud University","place":["Riyadh, Saudi Arabia"],"department":["Optometry Department, College of Applied Medical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meshary","family":"Alrumizan","sequence":"additional","affiliation":[{"name":"King Saud University","place":["Riyadh, Saudi Arabia"],"department":["Optometry Department, College of Applied Medical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Abusharha","sequence":"additional","affiliation":[{"name":"King Saud University","place":["Riyadh, Saudi Arabia"],"department":["Optometry Department, College of Applied Medical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"issue":"3","key":"pone.0360762.ref001","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jtos.2017.05.008","article-title":"TFOS DEWS II Definition and Classification Report","volume":"15","author":"JP Craig","year":"2017","journal-title":"Ocul Surf"},{"issue":"3","key":"pone.0360762.ref002","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jtos.2017.05.003","article-title":"TFOS DEWS II Epidemiology Report","volume":"15","author":"F Stapleton","year":"2017","journal-title":"Ocul Surf"},{"key":"pone.0360762.ref003","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ajo.2017.06.033","article-title":"Prevalence of diagnosed dry eye disease in the United States among adults aged 18 years and older","volume":"182","author":"KF Farrand","year":"2017","journal-title":"Am J Ophthalmol"},{"issue":"2","key":"pone.0360762.ref004","doi-asserted-by":"crossref","first-page":"67","DOI":"10.4103\/meajo.MEAJO_281_16","article-title":"Prevalence and Risk Factors of Dry Eye Symptoms in a Saudi Arabian Population","volume":"24","author":"AA Alshamrani","year":"2017","journal-title":"Middle East Afr J Ophthalmol"},{"key":"pone.0360762.ref005","doi-asserted-by":"crossref","first-page":"3811","DOI":"10.2147\/OPTH.S321591","article-title":"The Relationship Between Dry Eye Disease and Digital Screen Use","volume":"15","author":"Z Al-Mohtaseb","year":"2021","journal-title":"Clin Ophthalmol"},{"issue":"3","key":"pone.0360762.ref006","doi-asserted-by":"crossref","first-page":"242","DOI":"10.4103\/sjmms.sjmms_251_22","article-title":"Prevalence and Risk Factors of Dry Eye Disease among Adults in Saudi Arabia","volume":"11","author":"HB Helayel","year":"2023","journal-title":"Saudi J Med Med Sci"},{"issue":"2","key":"pone.0360762.ref007","doi-asserted-by":"crossref","first-page":"101770","DOI":"10.1016\/j.clae.2022.101770","article-title":"Estimates of dry eye disease in Saudi Arabia based on a short questionnaire of prevalence, symptoms, and risk factors: The Twaiq Mountain Eye Study I","volume":"46","author":"SA Alkhaldi","year":"2023","journal-title":"Cont Lens Anterior Eye"},{"issue":"9","key":"pone.0360762.ref008","article-title":"Dry Eye Disease Prevalence and Associated Risk Factors Among the Middle East Population: A Systematic Review and Meta-Analysis","volume":"16","author":"Z Mohamed","year":"2024","journal-title":"Cureus"},{"issue":"1","key":"pone.0360762.ref009","doi-asserted-by":"crossref","first-page":"15149","DOI":"10.1038\/s41598-024-65297-6","article-title":"The severity of dry eye symptoms and risk factors among university students in Saudi Arabia: a cross-sectional study","volume":"14","author":"A Alqurashi","year":"2024","journal-title":"Sci Rep"},{"issue":"12","key":"pone.0360762.ref010","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1001\/jamaophthalmol.2022.4394","article-title":"Prevalence and Incidence of Dry Eye and Meibomian Gland Dysfunction in the United States: A Systematic Review and Meta-analysis","volume":"140","author":"P McCann","year":"2022","journal-title":"JAMA Ophthalmol"},{"key":"pone.0360762.ref011","doi-asserted-by":"crossref","first-page":"2675","DOI":"10.2147\/OPTH.S313158","article-title":"Impact of dry eye disease on work productivity among Saudi workers in Saudi Arabia","volume":"15","author":"FH Binyousef","year":"2021","journal-title":"Clinical Ophthalmology"},{"issue":"4","key":"pone.0360762.ref012","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1167\/iovs.10-6997g","article-title":"The international workshop on meibomian gland dysfunction: report of the subcommittee on management and treatment of meibomian gland dysfunction","volume":"52","author":"G Geerling","year":"2011","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"4","key":"pone.0360762.ref013","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1167\/iovs.10-6997c","article-title":"The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland","volume":"52","author":"E Knop","year":"2011","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"2","key":"pone.0360762.ref014","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jtos.2014.12.002","article-title":"Meibomian glands and ocular surface inflammation","volume":"13","author":"T Suzuki","year":"2015","journal-title":"Ocul Surf"},{"issue":"1","key":"pone.0360762.ref015","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1089\/jop.2023.0080","article-title":"Evaluation of the Impact of Meibomian Gland Dysfunction Using a Novel Patient-Reported Outcome Instrument","volume":"40","author":"L Ajouz","year":"2024","journal-title":"J Ocul Pharmacol Ther"},{"key":"pone.0360762.ref016","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.ajo.2024.10.009","article-title":"Associations between dry eye disease and mental health conditions in the All of Us Research Program","volume":"270","author":"AT Zhao","year":"2025","journal-title":"Am J Ophthalmol"},{"issue":"4","key":"pone.0360762.ref017","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.jtos.2015.04.005","article-title":"Effects of Eyelid Warming Devices on Tear Film Parameters in Normal Subjects and Patients with Meibomian Gland Dysfunction","volume":"13","author":"R Arita","year":"2015","journal-title":"Ocul Surf"},{"issue":"2","key":"pone.0360762.ref018","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.jtos.2019.02.005","article-title":"The optimum temperature for the heat therapy for meibomian gland dysfunction","volume":"17","author":"D Borchman","year":"2019","journal-title":"Ocul Surf"},{"issue":"9","key":"pone.0360762.ref019","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.1007\/s40123-024-00988-x","article-title":"Evidence-Based Strategies for Warm Compress Therapy in Meibomian Gland Dysfunction","volume":"13","author":"G Lee","year":"2024","journal-title":"Ophthalmol Ther"},{"issue":"5","key":"pone.0360762.ref020","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1111\/aos.15052","article-title":"Chambered warm moist air eyelid warming devices - a review","volume":"100","author":"MS Magno","year":"2022","journal-title":"Acta Ophthalmol"},{"issue":"6","key":"pone.0360762.ref021","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.clae.2015.06.002","article-title":"Temperature profiles of patient-applied eyelid warming therapies","volume":"38","author":"MTM Wang","year":"2015","journal-title":"Cont Lens Anterior Eye"},{"issue":"1","key":"pone.0360762.ref022","doi-asserted-by":"crossref","first-page":"22386","DOI":"10.1038\/s41598-021-01899-8","article-title":"TheraPearl Eye Mask and Blephasteam for the treatment of meibomian gland dysfunction: a randomized, comparative clinical trial","volume":"11","author":"J Olafsson","year":"2021","journal-title":"Sci Rep"},{"issue":"2","key":"pone.0360762.ref023","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/01.ICL.0000060998.20142.8D","article-title":"Increase in tear film lipid layer thickness following treatment with warm compresses in patients with meibomian gland dysfunction","volume":"29","author":"MC Olson","year":"2003","journal-title":"Eye Contact Lens"},{"issue":"4","key":"pone.0360762.ref024","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1097\/ICL.0000000000000258","article-title":"Compliance and Subjective Patient Responses to Eyelid Hygiene","volume":"43","author":"YA Alghamdi","year":"2017","journal-title":"Eye Contact Lens"},{"key":"pone.0360762.ref025","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.2147\/OPTH.S360377","article-title":"Compliance with Lid Hygiene in Patients with Meibomian Gland Dysfunction","volume":"16","author":"V Chuckpaiwong","year":"2022","journal-title":"Clin Ophthalmol"},{"issue":"4","key":"pone.0360762.ref026","first-page":"274","article-title":"Effectiveness and safety of a thermo-mechanical action device versus thermal pulsation device in the treatment of meibomian gland dysfunction","volume":"51","author":"E Sadri","year":"2024","journal-title":"J Cataract Refract Surg"},{"key":"pone.0360762.ref027","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s40123-014-0025-8","article-title":"A Randomized, Controlled Treatment Trial of Eyelid-Warming Therapies in Meibomian Gland Dysfunction","volume":"3","author":"HS Sim","year":"2014","journal-title":"Ophthalmol Ther"},{"issue":"8","key":"pone.0360762.ref028","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1097\/OPX.0b013e318181adef","article-title":"Inner eyelid surface temperature as a function of warm compress methodology","volume":"85","author":"CA Blackie","year":"2008","journal-title":"Optom Vis Sci"},{"issue":"3","key":"pone.0360762.ref029","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1097\/ICO.0b013e31818913b4","article-title":"Recovery time of an optimally secreting meibomian gland","volume":"28","author":"CA Blackie","year":"2009","journal-title":"Cornea"},{"issue":"5","key":"pone.0360762.ref030","first-page":"71","article-title":"The pathophysiology, diagnosis, and treatment of dry eye disease","volume":"112","author":"EM Messmer","year":"2015","journal-title":"Dtsch Arztebl Int"},{"issue":"4","key":"pone.0360762.ref031","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1097\/ICO.0b013e3181f7f363","article-title":"The economic burden of dry eye disease in the United States: a decision tree analysis","volume":"30","author":"J Yu","year":"2011","journal-title":"Cornea"},{"issue":"2","key":"pone.0360762.ref032","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.clae.2011.08.003","article-title":"Non-contact meibography: keep it simple but effective","volume":"35","author":"H Pult","year":"2012","journal-title":"Cont Lens Anterior Eye"},{"issue":"4","key":"pone.0360762.ref033","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1167\/iovs.10-6997f","article-title":"The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee","volume":"52","author":"A Tomlinson","year":"2011","journal-title":"Invest Ophthalmol Vis Sci"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0360762","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:31:26Z","timestamp":1791912686000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0360762"}},"subtitle":[],"editor":[{"given":"Shiva Ram","family":"Male","sequence":"first","affiliation":[{"name":"University of Hyderabad","place":["INDIA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":33,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0360762","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]}}}