Comparison of the efficacy of topical N-acetyl-cysteine and a topical steroid-antibiotic combination therapy in the treatment of meibomian gland dysfunction

J Ocul Pharmacol Ther. 2012 Feb;28(1):49-52. doi: 10.1089/jop.2010.0110. Epub 2011 Jul 13.


Purpose: This study aimed to compare the efficacy of topical N-acetyl-cysteine (NAC) with a topical steroid-antibiotic combination, betamethasone-sulfacetamide sodium therapy in patients with meibomian gland dysfunction (MGD).

Methods: Twenty patients with MGD were prospectively randomized and assigned into 2 groups. The patients were instructed to use either NAC 5% or a topical steroid-antibiotic combination, betamethasone 0.1%-sulfacetamide sodium 10%, topically 4 times a day for a month. All patients were instructed to apply lid hygiene once daily.

Results: One month of topical therapy provided statistically significant improvements in fluorescein break-up time and Schirmer scores as compared with the initial study visit in both groups (P≤0.001). Significant improvements for the symptoms of ocular burning, itching, and intermittent filmy or blurred vision were noted in both groups at 1 month as compared with 1 day (P<0.05). Considering these rates, there was no significant difference between the groups (P>0.05). None of the patients developed an allergic reaction to the medications, and intraocular pressure measurements were within the normal limits in both groups.

Conclusion: When used in conjunction with eyelid hygiene, topical administration of NAC appears to be as effective as a topical steroid-antibiotic combination, betamethasone-sulfacetamide sodium therapy in patients with MGD.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetylcysteine / administration & dosage
  • Acetylcysteine / therapeutic use*
  • Administration, Topical
  • Adolescent
  • Adult
  • Anti-Infective Agents / administration & dosage
  • Anti-Infective Agents / therapeutic use
  • Betamethasone / administration & dosage
  • Betamethasone / therapeutic use*
  • Drug Combinations
  • Eyelid Diseases / drug therapy*
  • Eyelid Diseases / pathology
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Intraocular Pressure / drug effects
  • Male
  • Meibomian Glands / drug effects*
  • Meibomian Glands / pathology
  • Middle Aged
  • Prospective Studies
  • Sulfacetamide / administration & dosage
  • Sulfacetamide / therapeutic use*
  • Treatment Outcome
  • Young Adult


  • Anti-Infective Agents
  • Drug Combinations
  • Glucocorticoids
  • Sulfacetamide
  • Betamethasone
  • Acetylcysteine