Therapeutic Outcomes of Combined Eyelid Hygiene, Intense Pulsed Light, and Meibomian Gland Expression in Meibomian Gland Dysfunction

Abstract

Background/Objectives: This study aimed to assess the effectiveness of a combination therapy comprising eyelid hygiene, intense pulsed light (IPL), and meibomian gland expression in patients with meibomian gland dysfunction (MGD). Methods: This retrospective study included MGD patients who completed at least three sessions of combination therapy administered at 4-week intervals, with a minimum follow-up period of 6 months. Ocular surface parameters were evaluated at baseline and at 1, 3, and 6 months after treatment initiation. Based on the clinical response following the initial three sessions, patients were categorized into either the standard treatment group (3 sessions) or the extended treatment group, who received three additional sessions of the same combination therapy. Results: A total of 107 patients (77 females; 30 males) were enrolled. 74 patients received standard treatment, and 33 received extended treatment. In the standard group, significant improvements compared with baseline were observed in the Ocular Surface Disease Index score, non-invasive tear break-up time, corneal staining, lid margin plugging, telangiectasia, and the meibomian gland expressibility score. Conversely, in the extended group, only the meibomian gland expressibility score showed significant improvements at the 3-month follow-up. Conclusions: The standard combination therapy resulted in significant and durable improvements in approximately 70% of MGD patients, with effects persisting for at least 3 months post-treatment. These findings support the clinical utility of this multimodal approach and highlight the need for biomarkers to predict treatment response.

Keywords: dry eye disease; eyelid hygiene; intense pulsed light; meibomian gland dysfunction; meibomian gland expression.

Figure 1

Treatment and follow-up protocol for combined treatment with eyelid hygiene, intense pulsed light, and meibomian gland expression.

Figure 2

Changes in clinical parameters over time in the standard (three sessions) and extended (six sessions) treatment groups. * indicates an adjusted p-value showing a significant difference compared with the corresponding pretreatment value within the standard treatment group. ▲ indicates an adjusted p-value showing a significant difference compared with the corresponding pretreatment value within the extended treatment group. # indicates an adjusted p-value showing a significant difference between the standard and extended treatment groups at the specified time points.