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.

Figure 1

Total symptom scores. Notes: the total scores of the 10 single symptoms were defined as the total symptom scores. ^∗ Compared to the baseline, the total symptom score significantly decreased at the time of D15, D45, and D75 (P < 0.01). ^∗∗ Between the visits of D15 and D45, the total score continuously decreased (P = 0.04), while between the visits of D45 and D75, no significant difference was observed (P = 1). Statistical analysis was performed with paired t-test with the Bonferroni correction.

Figure 2

Meibomian gland secretion quality and expressibility. Notes: the y axis represents the level or grade of the meibomian gland secretion quality and expressibility, with higher grades meaning worse quality and expressibility. ^∗ Compared to the baseline, the meibomian gland secretion quality and expressibility significantly improved at the visits of D15, D45, and D75 (P < 0.05). ^∗∗ Between the visits of D15 and D45, the meibomian gland secretion quality and expressibility continuously improved (P < 0.05). Between the visits of D45 and D75, no significant difference was observed for the secretion quality (P = 0.68) and expressibility (P = 0.29). Statistical analysis was performed with paired t-test with the Bonferroni correction.

Figure 3

Tear break-up time (TBUT) and tear meniscus height (TMH). Notes: ^∗ TBUT at D15 (4.2 ± 1.8 s), D45 (5.0 ± 1.9 s), and D75 (4.5 ± 2.5 s) were significantly increased compared to that at the baseline (2.2 ± 1.5 s) (P < 0.01). Between the visits of D15 and D45, TBUT continuously increased while reaching no statistic difference (P = 0.07). Between the visits of D45 and D75, no significant difference was observed (P = 0.51). No significant difference was found in the assessment of upper and lower TMH in all visits. Statistical analysis was performed with paired t-test with the Bonferroni correction.