Treatment Effect and Pain During Treatment With Intense Pulsed-Light Therapy According to the Light Guide in Patients With Meibomian Gland Dysfunction

Abstract

We investigated whether there is a difference in the treatment effect and pain during the treatment of meibomian gland dysfunction (MGD) with intense pulsed-light (IPL) between new light guide and conventional light guide. Methods:We retrospectively reviewed medical records of 85 patients (170 eyes) who underwent IPL treatment of the upper and lower eyelids 3 times, at 3-week intervals, for MGD. Patients treated with the 6-mm or 8 • 15-mm cylindrical light guide were designated as group A or group B, respectively. The ocular surface disease index (OSDI), dry eye (DE), and MGD parameters were obtained before the first and after the third IPL treatments. Visual analog scale (VAS) scores were obtained at every IPL treatment. OSDI, DE, and MGD parameters and VAS scores were compared between the groups.Results: VAS scores at the first, second, and third IPL treatments were lower in group A than in group B. OSDI, DE, and MGD parameters were improved after 3 IPL treatments in both groups. There were no significant differences in OSDI, DE symptoms, and MGD parameters between before the first IPL treatment and after the third IPL treatment between the groups.Conclusions: Using the new 6-mm cylindrical light guide for IPL treatment in patients with MGD induced less pain during treatment and had similar treatment effects to the conventional 8 • 15-mm light guide. The new 6-mm cylindrical light guide can be useful when treating patients with dark or hyperpigmented skin and for pediatric patients with low compliance.

Effect of Intense Pulsed-Light Treatment Using a Novel Dual-Band Filter in Patients with Meibomian Gland Dysfunction

“…There are studies that have successfully treated facial acne vulgaris safely with an acne filter [26,27]. Many studies report the successful treatment of MGD patients using the M22 device [6,[13][14][15][18][19][20]28,29]. However, all these studies used the existing 590 nm filter, and studies reporting the use of the novel dual-band filters in the treatment of IPL in MGD patients are rare.…”

“…After a sufficient amount of ultrasound gel was applied to the target skin area, the clinician placed the Jaeger lid plate (Katena Products, Denville, NJ, USA) within the conjunctival sac to protect the eye. In the case of IPL treatment, an M22 Optima device (Lumenis, Yokneam, Israel) was used, and the duration and interval were set as 6.0 msec and 60.0 msec, respectively; additionally, a 6 mm cylindrical light guide was applied [20]. In the case of the filter, a novel dual-band filter (vascular filter) or a 590 nm filter was used.…”

“…In the case of the filter, a novel dual-band filter (vascular filter) or a 590 nm filter was used. The fluence was set according to Fitzpatrick skin types (13-19 J/cm 2 ), as described in previous studies [14,16,20]. Subsequently, 12 IPL pulses were then applied to the upper and lower eyelids [16,20].…”

“…The fluence was set according to Fitzpatrick skin types (13-19 J/cm 2 ), as described in previous studies [14,16,20]. Subsequently, 12 IPL pulses were then applied to the upper and lower eyelids [16,20]. Once the IPL treatment was finished, meibomian gland expression was performed with an Arita Meibomian Gland Compressor (Katena Products, Denville, NJ, USA).…”

“…The M22 Optima device (Lumenis, Yokneam, Israel) is one of the most widely used IPL machines for MGD treatment [6,[13][14][15][16][17][18][19][20]. The M22 has various filters and can be used according to the treatment purpose, and a novel dual-band filter (vascular filter, wavelengths 530-650 nm and 900-1200 nm), designed particularly for fine telangiectasia treatment, was introduced recently.…”