Evaluation of the Safety and Effectiveness of Intense Pulsed Light in the Treatment of Meibomian Gland Dysfunction

Abstract

Purpose. This study aims to explore the safety and efficacy of a novel treatment-intense pulsed light (IPL) in MGD eyes. Methods. This study is a prospective and open label study. Forty eyes of 40 MGD patients were recruited in the study and received 4 consecutive IPL treatments on day 1, day 15, day 45, and day 75. Ten ocular surface symptoms were evaluated with a subjective face score at every visit. Best spectacle corrected visual acuity, intraocular pressure (IOP), conjunctival injection, upper and lower tear meniscus height (TMH), tear break-up time (TBUT), corneal staining, lid margin and meibomian gland assessments, and meibography were also recorded at every visit, as well as the adverse effects on the eye and ocular surface. Results. Significant improvements were observed in single and total ocular surface symptom scores, TBUT, and conjunctival injection at all the visits after the initial IPL treatment (P < 0.05). Compared to baseline, the signs of eyelid margin, meibomian gland secretion quality, and expressibility were significantly improved at every visit after treatments. There was no regional and systemic threat observed in any patient. Conclusion. Intense pulsed light (IPL) therapy is a safe and efficient treatment in relieving symptoms and signs of MGD eyes.

Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction

“…Our results are in agreement with several trials, which have demonstrated the efficacy of IPL for the treatment of MGD 13–17. The mechanism of action is, however, not known.…”

“…The first suggestion that IPL might improve MGD came from Toyos, who observed that rosacea subjects treated with IPL reported an improvement in their DED symptoms 12. Since then, several studies have shown that IPL therapy has a beneficial effect on MGD in patients with and without rosacea 13–17…”

Intense pulsed light treatment and meibomian gland expression for moderate to advanced meibomian gland dysfunction

“…The device and the nature of the light it emits have been reviewed . Following reports that serial periocular intense pulsed light treatments improve signs and symptoms of dry eyes in individuals with acne rosacea and ocular surface disease, the clinical application of intense pulsed light devices have been extended to include the treatment of MGD …”

“…The emerging clinical data regarding the safety and efficacy of intense pulsed light treatment for MGD suggests that a series of two or more intense pulsed light treatments can improve symptoms, tear film characteristics, including tear film break‐up time and clinical signs of MGD; however clinical guidelines regarding candidate selection, the number and frequency of treatments and the efficacy of post‐intense pulsed light meibomian gland expression (MGX) are yet to be established. At the time of writing, of the five published studies assessing the efficacy of intense pulsed light as a treatment for MGD, three were retrospective reviews of treatment series involving individuals with moderate to advanced MGD treated with the Quadra Q4 (DermaMed Solutions, LLC, Lenni, Pennsylvania, USA) intense pulsed light system using a proprietary ‘dry eye mode’ setting.…”

TMIS: a new image‐based software application for the measurement of tear meniscus height

“…A total of 5 μ l of 2% sodium fluorescein was instilled into the inferior conjunctival cul‐de‐sac of both eyes of each subject using a micropipette, without touching the ocular or the lid surface by the micropipette (Jiang et al. ). The subject was asked to blink naturally without squeezing three to five times to ensure proper mixing of the fluorescein dye throughout the tear film.…”