Long-Term Effects of Intense Pulsed Light Combined with Meibomian Gland Expression in the Treatment of Meibomian Gland Dysfunction.

Abstract

To evaluate the long-term effects of intense pulsed light (IPL) combined with meibomian gland expression (MGX) in the treatment of meibomian gland dysfunction (MGD). Although IPL has been proven to be effective in the treatment of MGD, any report regarding its long-term efficacy is unavailable by now. The randomly selected study eye received a series of three IPL treatments that were applied directly on eyelids with an interval of 4 weeks (treatment energy, 14-16 J/cm2). The control eye received three sham IPL treatments (0 J/cm2). MGX was performed on both eyes. Meibomian gland yielding secretion score (MGYSS) and tear film break-up time (TBUT) were evaluated at baseline and at 1, 3, 6, and 9 months after treatments. In the study eyes, MGYSS of both the upper and lower eyelids and TBUT improved at 1, 3, 6 months after treatments (p < 0.01). MGYSS in lower eyelids continued to improve at 9 months (p < 0.05). The changes in MGYSS and TBUT after treatment were larger in the study eyes than in the control eyes at 1, 3, 6 months (p < 0.01), but no difference at 9 months (p > 0.05). The percentage improvement in the MGYSS of lower eyelids after treatment was higher than that of upper eyelids. Three consecutive IPL treatments combined with MGX improved MG secretion function and TBUT by 6 months after treatment in MGD patients. The improvement in MG secretion function was greater in the lower eyelid than in the upper eyelid.