Efficacy and Safety of Intense Pulsed Light in Patients With Meibomian Gland Dysfunction—A Randomized, Double-Masked, Sham-Controlled Clinical Trial

Piyacomn, Yonrawee; Kasetsuwan, Ngamjit; Reinprayoon, Usanee; Satitpitakul, Vannarut; Tesapirat, Lita

doi:10.1097/ico.0000000000002204

Cited by 62 publications

(88 citation statements)

References 21 publications

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“…A second limitation is that our study had a 2-week interval between treatments, which is different from the widely accepted protocol of a 3-week or longer interval. However, several studies have reported 2-week interval IPL treatment as effective in MGD and dry eye syndrome [ 36 ], and the disease begin to improve 2 weeks after IPL treatment [ 19 , 37 ]. Therefore, the investigators believe the protocol in the present study is also effective in treating MGD and is worth reporting.…”

Section: Resultsmentioning

confidence: 99%

Intense pulsed light plus meibomian gland expression versus intense pulsed light alone for meibomian gland dysfunction: A randomized crossover study

Shin¹,

Lim

Moon

et al. 2021

PLoS ONE

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Purpose To investigate the comparative efficacy of intense pulsed light (IPL) therapy alone with that of IPL plus meibomian gland expression (MGX) for meibomian gland dysfunction (MGD). Methods This is a prospective randomized crossover clinical trial. Sixty patients were enrolled and randomly assigned to two groups. All of patients underwent four treatment sessions in total, which were two weeks apart. Group 1 underwent two sessions of IPL therapy with MGX, as well as two sessions of IPL alone. Group 2 received two sessions of IPL therapy alone, and two sessions of IPL therapy with MGX. The following parameters were measured at baseline (BL), 2 weeks after the second treatment session (FU1), and 2 weeks after the fourth treatment session (FU2): tearfilm break-up time (BUT), Oxford grade for corneal staining, meibomian gland expressibility (MGE), meibum quality (MQ), and ocular surface disease index (OSDI). The separate effect of MGX on improvement of MGD parameters was evaluated using generalized estimating equation (GEE). Results The mean age of the participants was 57.52 ± 10.50 years. The BUT, Oxford grade, MGE, MQ, and OSDI of both groups improved significantly (from baseline) by the end of four treatment sessions (FU2 compared to BL; all p-values <0.05). The MGE and MQ significantly improved after the first and second treatment sessions (FU1 compare to BL; all p-values < 0.001). However, the improvement was not statistically significant after the third and fourth treatment sessions (FU2 compared to FU1; p-value of 0.388 for MGE and 0.645 for MQ in group 1, 0.333 for MGE and 0.333 for MQ in group 2). The IPL plus MGX therapy produced greater improvements in the BUT scores than did IPL therapy alone (p = 0.003 by GEE). In contrast, the Oxford grade, MGE, MQ, and OSDI were not influenced by the addition of MGX to IPL (p = 0.642, 0.663, 0.731, and 0.840, respectively by GEE). Conclusion IPL therapy effectively improves the subjective symptoms and objective ocular findings of MGD. MGX enhanced the improvement of BUT driven by IPL therapy. The meibomian gland function (MGE and MQ) recovers faster in response to IPL therapy than did the other parameters.

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Section: Resultsmentioning

confidence: 99%

Intense pulsed light plus meibomian gland expression versus intense pulsed light alone for meibomian gland dysfunction: A randomized crossover study

Shin¹,

Lim

Moon

et al. 2021

PLoS ONE

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“…The MG inflammation would be reduced by the removal of these blood vessels [ 68 ] and also because of photomodulation. According to the studies by Liu et al [ 69 ] and Piyacomn et al [ 70 ] (I), this process would reduce some inflammatory mediators such as interleukin (IL)-17A, IL-6, or IL-1Ra.…”

Section: Light-based Devicesmentioning

confidence: 99%

“…There are some differences between both devices such as the treatment schedule. The E > Eye system is usually applied in three or four sessions, performed on days 1, 15, 45, and 75 [ 63 , 70 , 71 ], while the M22 system is usually applied in three sessions, separated by 3 or 4 weeks [ 62 , 71 , 72 ]. The spot size is 15 × 40 mm in E > Eye and 15 × 35 mm in the M22, and the cooling system is Airflow in the E > Eye and ChillTip™ Contact in the M22.…”

Section: Light-based Devicesmentioning

confidence: 99%

“…Several studies evaluated the IPL treatment along with other treatments. Piyacomn et al [ 70 ] (I) observed a higher and faster improvement in the MG function in patients who combined conventional eyelid hygiene and IPL than in those patients who performed hygiene alone. Huang et al [ 72 ] (I) compared IPL with intraductal MG probing.…”

Section: Light-based Devicesmentioning

confidence: 99%

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Therapeutic Instruments Targeting Meibomian Gland Dysfunction

et al. 2020

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The most prevalent type of meibomian gland dysfunction (MGD), which is obstructive, is the main cause of evaporative dry eye and is characterized by changes in the meibum composition and duct obstruction. Eyelid hygiene has usually been the most common clinical approach. However, alternative therapies for MGD are emerging on the market. Some warming and humidity devices have led to an improvement in the signs and symptoms in MGD patients. Likewise, eyelid massaging and cleaning devices are also beneficial for ocular signs and symptoms; however, patients usually need more than one session to maintain the therapeutic effect. Thermal pulsation has been reported to be more efficient than other strategies, and the effects can last up to 12 months. Moreover, intense pulsed light therapy has been demonstrated to improve ocular signs and symptoms alone and in combination with other therapies. Proper counseling of clinicians considering MGD status and patient compliance will help patients to undergo the adequate technique that best suits their condition.

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“…6 Although its mechanisms of therapeutic action are still being investigated, [7][8][9] some randomized trials and several case series have shown that IPL is safe and effective in improving MGD and reducing symptoms of DED. [10][11][12][13][14] Another kind of photobiomodulation is the Low-Level Light Therapy (LLLT). This technique uses light-emitting diodes (LEDs) at wavelengths insufficient to produce a thermal effect (often 590-633 nm), but that increases photon intensity and its capacity to penetrate below the skin, inducing cellular photoactivation.…”

Section: Introductionmentioning

confidence: 99%

Combined Intense Pulsed Light and Low-Level Light Therapy for the Treatment of Dry Eye: A Retrospective Before–After Study with One-Year Follow-Up

Pérez-Silguero¹,

Pérez-Silguero²,

Rivero‐Santana³

et al. 2021

OPTH

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Purpose: To assess the effectiveness of a combination of intense pulsed light and low-level light therapy (IPL/LLLT) for the treatment of dry eye. Study Design: Retrospective before-after single-center clinical study. Materials and Methods: Patients diagnosed with dry eye, refractory to conventional treatment, underwent four sessions of combined IPL/LLLT over 3 months. The Ocular Surface Disease Index (OSDI) questionnaire, non-invasive breakup time (NIBUT), tear film osmolarity and meniscus height were measured 6 months before intervention, at baseline, post-intervention (3 months), 9 and 15 months. Results: NIBUT, osmolarity and meniscus height significantly worsened during the 6 months before treatment, whereas symptoms did not change. OSDI scores significantly improved at post-intervention (MD = −44.0, 95% CI −38.1, −50.0), and then increased again until the at last follow-up, but still significantly different from baseline (MD = −30.0, 95% CI −23.4, −36.8). The three clinical signs showed a similar pattern, with one-year improvements of 3.6 seconds for the NIBUT (95% CI 3.1, 4.2, p <0.001), 28 mOsm/L for osmolarity (95% CI 23.6, 32.4, p <0.001) and 0.03 mm for meniscus height (95% CI 0.02, 0.04, p <0.001). No adverse effects were observed. Conclusion: IPL/LLLT is safe and produces an important reduction in symptoms and signs of dry eye disease, still relevant one year after the end of treatment in a sample with high symptoms' severity. Therefore, it represents a promising treatment option for patients who do not improve with conventional treatment. Randomized trials are needed to determine the added benefit provided by LLLT.

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Efficacy and Safety of Intense Pulsed Light in Patients With Meibomian Gland Dysfunction—A Randomized, Double-Masked, Sham-Controlled Clinical Trial

Cited by 62 publications

References 21 publications

Intense pulsed light plus meibomian gland expression versus intense pulsed light alone for meibomian gland dysfunction: A randomized crossover study

Intense pulsed light plus meibomian gland expression versus intense pulsed light alone for meibomian gland dysfunction: A randomized crossover study

Therapeutic Instruments Targeting Meibomian Gland Dysfunction

Combined Intense Pulsed Light and Low-Level Light Therapy for the Treatment of Dry Eye: A Retrospective Before–After Study with One-Year Follow-Up

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