Investigation of Prognostic Factors for Intense Pulsed Light Treatment with a Vascular Filter in Patients with Moderate or Severe Meibomian Gland Dysfunction

Abstract

We aimed to investigate the prognostic factors for, and treatment efficacy of, intense pulsed light (IPL) treatment with a vascular filter in patients with moderate or severe meibomian gland dysfunction (MGD). In this retrospective observational study, 58 moderate or severe MGD patients who underwent IPL treatment with a vascular filter were enrolled. IPL treatment was administered to the upper and lower eyelids four times at two-week intervals. At baseline, and four weeks after IPL, we evaluated the matrix metalloproteinase (MMP)-9 expression levels, tear break-up times (TBUT), ocular surface staining scores, lid margin telangiectasias, and meibomian gland characteristics. The subjective symptoms and adverse effects were reviewed and recorded. Regression analyses were performed to explore the prognostic factors affecting clinical outcomes. IPL treatment using a vascular filter led to improvements in the TBUT, ocular surface staining score, meibomian gland grade, meibum quality and consistency, lid margin telangiectasia, and symptom score (all p < 0.001). Furthermore, the positivity rate (90.2% to 70.6%, p = 0.013) and expression levels (1.92 ± 1.18 to 1.24 ± 1.18, p < 0.001) of tear MMP-9 improved after the IPL treatment. In multivariate logistic regression analysis, a young age (odds ratio = 0.867, p = 0.007) and a toothpaste-like consistency in the upper lid (odds ratio = 8.449, p = 0.046) were associated with improvements in the meibomian gland grade. No adverse effects were detected. IPL with a vascular filter is a safe and effective treatment for moderate and severe MGD. Age and the meibum consistency in the upper lid are important prognostic factors.

Comparative Efficacy Between Intense Pulsed Light Narrow Spectrum and Broad Spectrum in the Treatment of Post-Acne Erythema (PAE)

“…Such exclusion of these wavelengths reduces the risk of overheating the epidermis and increases the amount of light absorbed by haemoglobin. 45 …”

“…The vascular filter decreases the amount Such exclusion of these wavelengths reduces the risk of overheating the epidermis and increases the amount of light absorbed by haemoglobin. 45 Theoretically, chemical reactions directly depend on temperature. The higher the temperature, the faster a given chemical reaction will proceed to destroy the P. acnes.…”

Intense pulsed light treatment for the management of meibomian gland dysfunction

“…Few studies have investigated which patient population might benefit the most from IPL therapy. Patients who are younger tend to respond better to IPL [41,42]. Additionally, patients with moderate MGD, compared to severe MGD, seem to have a greater benefit with IPL therapy [43].…”

Novel treatment of chalazion using light-guided-tip intense pulsed light

“…The results showed that following surgery, patients who had IPL-MGX therapy saw a substantial improvement in meibomian gland function and a reduction in chalazion recurrence. IPL warms the skin internally to 50 °C helps liquefy aberrant meibum and assists telangiectasias to absorb more energy to closure abnormal vessels 14 , 15 . This has led to the interest in IPL as a potential therapy for chalazion.…”