Abstract: Objective To investigate the changes of meibomian gland function related indexes after conventional treatment combined with 0.01% hypochlorous acid eye solution for cleaning the palpebral marginal in the treatment of moderate and severe meibomian gland dysfunction (MGD). Methods A total of 90 MGD patients (90 eyes) who were diagnosed in the Affiliated Hospital of Xuzhou Medical University from May 2021 to October 2021 were enrolled. They were randomly divided into two groups (n=45). The control group was subjected to warm compresses, meibomian gland massage and treatment with 0.3% sodium hyaluronate eye solution. In addition to the basic treatment as the control group, the study group was subjected to palpebral marginal cleaning with 0.01% hypochlorous acid eye solution. Both groups were compared for ocular surface disease index (OSDI), non-invasive tear meniscus height (NITMH), non-invasive first tear film break-up time (NIBUT_f), non-invasive average tear film break-up time (NIBUT_av), lipid layer analysis, meibomian gland loss score, the degree of eyelid margin hyperemia score and meibomian gland secretion score before treatment and 1 week, 2 weeks, 1 month and 3 months after treatment. Results Compared with the control group, the study group showed statistical differences in NITMH, lipid layer analysis and the degree of eyelid margin hyperemia 2 weeks and 3 months after treatment, in NIBUT_f 1 month and 3 months after treatment,in OSDI and NIBUT_av 2 weeks, 1 month and 3 months after treatment, and in meibomian gland secretion at each time point after treatment (P<0.05). Conclusions Conventional treatment combined with 0.01% hypochlorous acid for cleaning palpebral margin can significantly relieve the symptoms and signs of MGD patients, and improve their tear film stability, with a great application prospect.