Abstract
Aqueous-deficient dry eye (ADDE) and meibomian gland dysfunction (MGD) can be refractory to therapy. Intense pulsed light (IPL) was recently introduced as an effective treatment for MGD. We here evaluated the efficacy of IPL combined with MG expression (MGX) compared with MGX alone (n = 23 and 20, respectively) for patients with refractory ADDE with mild MGD at three sites. Symptom score, visual acuity (VA), noninvasive breakup time (NIBUT) and lipid layer thickness (LLT) of the tear film, lid margin abnormalities, fluorescein BUT (FBUT), fluorescein staining, tear meniscus height (TMH), meibum grade, meiboscore, and Schirmer’s test value were assessed at baseline and 1 and 3 months after treatment. LLT, plugging, vascularity, FBUT and NIBUT were improved only in the IPL-MGX group at three months compared with baseline. All parameters with the exception of VA, meiboscore, TMH, Schirmer’s test value were also improved in the IPL-MGX group compared with the control group at three months, as was VA in patients with central corneal epitheliopathy. Although IPL-MGX does not affect aqueous layer, the induced improvement in quality and quantity of the lipid layer may increase tear film stability and ameliorate symptoms not only for evaporative dry eye but for ADDE.
Highlights
Dry eye disease is a common condition that causes ocular discomfort [1]
We have performed a multicenter, retrospective, controlled study to evaluate the efficacy of Intense pulsed light (IPL) combined with MG expression (MGX) in comparison with MGX alone in patients with refractory aqueous-deficient dry eye (ADDE) and mild meibomian gland dysfunction (MGD) who had been treated with conventional therapies
Lid margin abnormalities [34], fluorescein BUT (FBUT), the Fluo score [32], tear meniscus height (TMH) based on fluorescein staining, and meibum grade [35] were evaluated with a slitlamp microscope
Summary
Dry eye disease is a common condition that causes ocular discomfort [1]. it generally does not reduce conventionally tested visual acuity (VA), most individuals with this condition manifest impairment of functional visual acuity, with higher-order aberrations in particular leading to disturbance of quality of vision [2]. Subsequent studies found that IPL, with or without concomitant meibomian gland expression (MGX), is effective for improvement of subjective symptoms and objective findings in patients with mild to moderate MGD or dry eye [17,18,19,20,21,22,23,24,25,26,27,28]. The combination of IPL and MGX was shown to be effective in patients with refractory MGD [28,29] It ameliorated dry eye symptoms and improved meibomian gland function in patients with refractory dry eye, including individuals with MGD and those with graft-versus-host disease or Sjögren syndrome [20] or those with keratoconjunctivitis sicca [30]. We have performed a multicenter, retrospective, controlled study to evaluate the efficacy of IPL combined with MGX in comparison with MGX alone in patients with refractory ADDE and mild MGD who had been treated with conventional therapies
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