Elsevier

The Ocular Surface

Volume 17, Issue 1, January 2019, Pages 104-110
The Ocular Surface

Original Research
Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction

https://doi.org/10.1016/j.jtos.2018.11.004Get rights and content
Under a Creative Commons license
open access

Abstract

Purpose

To evaluate the efficacy and safety of intense pulsed light (IPL) combined with meibomian gland expression (MGX) for treatment of refractory meibomian gland dysfunction (MGD).

Methods

Ninety eyes of 45 patients were randomly assigned to receive either the combination of IPL and MGX or MGX alone (control). Each eye underwent eight treatment sessions at 3-week intervals. Parameters were evaluated before and during treatment as well as at 3–11 weeks after the last treatment session. Measured parameters included the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire score, noninvasive breakup time (NIBUT), fluorescein breakup time (BUT), lipid layer grade, lipid layer thickness (LLT), lid margin abnormalities, corneal and conjunctival fluorescein staining (CFS) score, meibum grade, and meiboscore.

Results

A significant improvement in lipid layer grade was apparent in the IPL-MGX group from 6 to 32 weeks after treatment onset (adjusted P < 0.001) but was not observed in the control group. The IPL-MGX group also showed significant improvements in LLT, NIBUT, BUT, lid margin abnormalities, and meibum grade compared with the control group at 24 and 32 weeks (adjusted P < 0.001) as well as significant improvements in the SPEED score at 32 weeks (adjusted P = 0.044) and in CFS score at 24 (adjusted P = 0.015) and 32 (adjusted P = 0.006) weeks.

Conclusions

The combination of IPL and MGX improved homeostasis of the tear film and ameliorated ocular symptoms in patients with refractory MGD and is thus a promising modality for treatment of this condition.

Keywords

Dry eye
Intense pulsed light
Meibomian gland dysfunction
Meibomian gland expression
Meibum

Abbreviations/acronyms

IPL
intense pulsed light
MGD
meibomian gland dysfunction
MGX
meibomian gland expression
LLT
lipid layer thickness
NIBUT
noninvasive breakup time
BUT
breakup time
CFS
corneal and conjunctival fluorescein staining
SPEED
Standard Patient Evaluation of Eye Dryness

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