To Compare Blephapad Combo vs Standard Treatment for Eyelid Cleansing in Bilateral Posterior Blepharitis

The total score of the meibomian gland dysfunction (MGD) grading scale was automatically computed by the system as the sum of the six sub-scores (i.e. Lid margin findings of vascularity, Plugging of gland orifices, Lid margin irregularity, Lid margin thickening, Partial glands and Gland dropout), ranging from 0 to 15, where higher values rapresent a worse outcome. The first four parameters were evaluated using photographic images of anterior segments, while the last two were evaluated using infrared images of the meibomian glands Based on the percentage change from baseline to week 4 of the total score of MGD score, Investigators will choose which of the two eyes had a better change of clinical features.

Time frame: from baseline to week 4

Population: patients with symmetrical bilateral posterior blepharitis

For each eye change from baseline to week 4 in the total score of Meibomian Gland Dysfunction was also expressed as one of the following outcomes: 1. Eye on Blephapad Combo: Improved-Eye on Standard: Improved 2. Eye on Blephapad Combo: Improved-Eye on Standard: NOT Improved 3. Eye on Blephapad Combo: NOT Improved-Eye on Standard: Improved 4. Eye on Blephapad Combo: NOT Improved-Eye on Standard: NOT Improved The total score was automatically computed by the system as the sum of the six sub-scores (i.e. Lid margin findings of vascularity, Plugging of gland orifices, Lid margin irregularity, Lid margin thickening, Partial glands and Gland dropout), ranging from 0 to 15 (higher values rapresent a worse outcome).If the change of the total score was positive or equal to 0 the specific eye was referred as NOT improved,on the contrary if the change of the total score resulted negative the specific eye was referred as Improved. For each patient the results on the two eyes were combined.

Time frame: From Visit 2 (baseline) to Visit 3 (week 4)

Population: Patiens with symmetrical bilateral posterior blepharitis who applied treatment at least once in one eye and had a baseline evaluation of the primary efficacy endpoint.

At the end of study patients was asked to state their preference on the treatments used.

Time frame: at Visit 3 (week 4)

Population: Patiens with symmetrical bilateral posterior blepharitis who applied treatment at least once in one eye and had a baseline evaluation of the primary efficacy endpoint. One patient didn't express the preference therefore 17 patients were considered.

Adherence to treatment was evaluated at Visit 3 by counting given wipes/gauze and unused/lost/damaged wipes/gauze. The compliance to treatment was evaluated by counting given wipes/gauze and unused/lost/damaged wipes/gauze. The following formula was applied: (Given wipes/gauze - (sum of unused/lost/damaged wipes/gauze)) / Expected number of wipes/gauze used) x 100. Where the given wipes/gauze were 60 and the expected number of wipes/gauze used were 2 per days per 4 weeks = 56.

Time frame: From Visit 2 (baseline) to Visit 3 (week 4)

Population: Patiens with symmetrical bilateral posterior blepharitis who applied treatment at least once in one eye.

A targeted physical examination was performed at all visits and monitoring for ocular and systemic adverse events occurred throughout the study

Time frame: From Visit 2 (baseline) to Visit 3 (week 4)

Population: Patiens with symmetrical bilateral posterior blepharitis who applied treatment at least once in one eye.~One patient reported a treatment-emergent systemic adverse event, i.e. Suspected colon cancer of mild severity that led to permanent treatment discontinuation.