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

Shin, Kyoung Yoon; Lim, Dong Hui; Moon, Chang-Hyun; Kim, Byung Jin; Chung, Tae‐Young

doi:10.1371/journal.pone.0246245

Cited by 21 publications

(17 citation statements)

References 36 publications

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“…Using the OSDI questionnaire and the subject’s report of daily use of artificial tears, both study and control subjects improved but the difference between the two arms was mostly negligible. These results are in agreement with other studies with similar designs [ 25 , 29 ]. Using the EDS questionnaire, in contrast, there was more improvement in study compared to control subjects.…”

Section: Discussionsupporting

confidence: 94%

Intense pulsed light improves signs and symptoms of dry eye disease due to meibomian gland dysfunction: A randomized controlled study

et al. 2022

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Purpose To compare the safety and efficacy of intense pulsed light (IPL) followed by meibomian gland expression (MGX), against monotherapy of MGX. Methods Patients with moderate to severe meibomian gland dysfunction (MGD) were 1:1 randomized to 4 sessions of intense pulse light + MGX at 2-week intervals, or 4 sessions of Sham + MGX at 2-week intervals. Both patients and examiners were blinded to the allocation. Outcome measures, evaluated at the baseline (BL) and at a follow-up (FU) conducted 4 weeks after the last IPL session, included fluorescein tear breakup time (TBUT) as the primary outcome measure, OSDI (Ocular Surface Disease Index) questionnaire, Eye Dryness Score (EDS, a visual analog scale (VAS)-based questionnaire), Meibomian gland score (MGS, a score of meibum expressibility and quality in 15 glands on the lower eyelid), daily use of artificial tears, and daily use of warm compresses. In addition, during each treatment session, the number of expressible glands was counted in both eyelids, the predominant quality of meibum was estimated in both eyelids, and the level of pain/discomfort due to MGX and IPL was recorded. Results TBUT increased from 3.8±0.2 (μ±standard error of mean (SEM)) to 4.5±0.3 seconds in the control arm, and from 4.0±0.2 to 6.0±0.3 in the study arm. The difference between arms was statistically significant (P < .01). Other signs/symptoms which improved in both arms but were greater in the study arm included MGS (P < .001), EDS (P < .01), the number of expressible glands in the lower eyelids (P < .0001) and upper eyelid (P < .0001), the predominant meibum quality in the lower eyelid (P < .0001) and upper eyelid (P < .0001), and the level of pain due to MGX (P < .0001). Outcome measures which improved in both arms with no significant differences between the two were OSDI (P = .9984), and the daily use of artificial tears (P = .8216). Meibography, daily use of warm compresses, and severity of skin rosacea did not show statistically significant changes in either arm. No serious adverse events were observed. There was a slight tendency for more adverse events in the control group (P = 0.06). Conclusions The results of this study suggest that, in patients with moderate to severe symptoms, combination therapy of intense pulse light (IPL) and meibomian gland expression (MGX) could be a safe and useful approach for improving signs of dry eye disease (DED) due to meibomian gland dysfunction (MGD). Future studies are needed to elucidate if and how such improvements can be generalized to different severity levels of MGD.

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Section: Discussionsupporting

confidence: 94%

Intense pulsed light improves signs and symptoms of dry eye disease due to meibomian gland dysfunction: A randomized controlled study

et al. 2022

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“… 78 44 Improved symptoms Improved tear stability Improved meibomian gland function No adverse events Lumenis M22 alone Lumenis M22 + expression Shin et al Intense pulsed light plus meibomian gland expression versus intense pulsed light alone for meibomian gland dysfunction: A randomized crossover study. 76 72 Improved symptoms Improved tear stability Improved meibomian gland function No adverse events Lumenis M22 Tang et al A Retrospective Study of Treatment Outcomes and Prognostic Factors of Intense Pulsed Light Therapy Combined With Meibomian Gland Expression in Patients With Meibomian Gland Dysfunction. 77 44 Improved symptoms Improved tear stability Improved meibomian gland function Not reported Lumenis M22 Yan et al The Efficacy of Intense Pulsed Light Combined With Meibomian Gland Expression for the Treatment of Dry Eye Disease Due to Meibomian Gland Dysfunction: A Multicenter, Randomized Controlled Trial.…”

Section: Methodsmentioning

confidence: 99%

“…While the efficacy of IPL in treating MGD has been demonstrated, there are no head-to-head studies to determine which system is superior. In addition to varied protocols for energy delivery, IPL may also be combined with other therapies, such as meibomian gland expression 58–61 , 63 , 69 , 76 and low-level light therapy. 67 , 70 , 71 …”

Section: Methodsmentioning

confidence: 99%

“…This review found 23 studies examining the efficacy of IPL in treating MGD (Table 5). IPL improved symptoms, tear stability, and meibomian gland function in 96% (22/23), 87% (20/23), [58][59][60][61][62][63][64][65][66][68][69][70][71][72][74][75][76][77][78][79] and 87% (20/23) of studies reviewed, [58][59][60][61][63][64][65][66][67][68][69][70][71][73][74][75][76][77][78][79] respectively. Two studies reported adverse events related to using IPL.…”

Section: Devices That Deliver a Combination Of Heat And Or Pressurementioning

confidence: 99%

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Eyelid Warming Devices: Safety, Efficacy, and Place in Therapy

Bzovey¹,

Ngo²

2022

OPTO

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Meibomian gland dysfunction (MGD) is characterized by the obstruction and/or inflammation of the meibomian glands that result in decreased and altered meibum secretion. This results in deficiencies in the tear film lipid layer which contributes to increased evaporation and destabilization of the tear film. One of the mainstay therapies for MGD is medical devices that apply heat and/or pressure to the eyelids and promote the liquification and outflow of meibum into the tear film. Over the past two decades, there have been a surge of interest in diagnosing and managing MGD. As a result, numerous medical devices have been developed and each have their own unique approach to treating MGD. This narrative review was conducted to summarize the current state of knowledge on eyelid warming devices, specifically warm eye coverings, devices that direct heat and/or pressure to the eyelids, moisture chamber goggles, and light-based therapy. This review summarized 58 human clinical studies and found that most eyelid warming devices were efficacious in improving signs and symptoms in a wide range of MGD severities and were generally safe to use.

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“…Импульсы света воздействуют на кожу щек, как правило, возле нижних век. В ходе одного сеанса используют 4-5 вспышек импульсного света [35,36].…”

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Modern Possibilities of Physiotherapeutic Treatment in Meibomian Gland Dysfunction

et al. 2022

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Currently, the main applied physiotherapeutic methods of treatment, whale, as well as the features of their application are considered. The basis of the meibomian glands dysfunction treatment is the hygiene of the eyelids. There are many modifications to the application of eyelid hygiene, but its basic principle is the use of warm compresses and eyelid massage. There are many modifications of warm compresses. Using them, it is necessary to remember about the possibility of the appearance of the cornea with various types of thermal effects on the eyelids when dysfunction of the meibomian glands is detected, therefore it is important to carefully dose the time of thermal exposure and temperature regime, which allows you to avoid side effects. The classic tool that a doctor uses to treat MGD — eyelid massage on a glass rod, has now been replaced by many high-tech devices for heating, moisturizing and massage of the eyelid. All commercial devices for the treatment of MGD on the world market can be divided into several groups, according to their effect: device for light therapy. The most high-tech devices include the LipiFlow® device (combined heat and eyelid massage) and the device for IPL therapy with intense pulsed light. many studies aimed at studying the effectiveness of various research methods. It should be noted that it is not by chance that in modern ophthalmological practice the range of new methods for studying MGD has expanded so much. This is due to the annual number of patients suffering from this pathology. Therefore, the urgent task is to search for new methods of treatment aimed at restoring the functional activity of the meibomian glands.

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

Cited by 21 publications

References 36 publications

Intense pulsed light improves signs and symptoms of dry eye disease due to meibomian gland dysfunction: A randomized controlled study

Intense pulsed light improves signs and symptoms of dry eye disease due to meibomian gland dysfunction: A randomized controlled study

Eyelid Warming Devices: Safety, Efficacy, and Place in Therapy

Modern Possibilities of Physiotherapeutic Treatment in Meibomian Gland Dysfunction

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