Abstract
Purpose Our study aimed to evaluate the efficiency of intense pulsed light (IPL) combined with meibomian gland expression (MGX) in treating meibomian gland dysfunction (MGD). Methods This study was a prospective interventional study. A total of 53 patients were included in the study and received a series of three treatments at an interval of 3-4 weeks. Follow-up examinations were completed 4 weeks after the last treatment. The Ocular Surface Disease Index (OSDI) questionnaire, tear meniscus height (TMH), tear break-up time (TBUT), slit-lamp examinations, and in vivo confocal microscopy (IVCM) were recorded before and after treatment. Additionally, an artificial intelligence automated software program was applied in our study for corneal nerve analysis. Results The OSDI score was significantly reduced after the IPL treatment compared with baseline (P < 0.001). Meibomian gland assessment scores, including meibum quality and expressibility, eyelid margin abnormalities, and corneal staining, significantly decreased after treatment (P < 0.05). Moreover, the corneal nerve fiber length (CNFL) significantly increased after the treatment (P < 0.001). Conclusion Intense pulsed light (IPL) combined with MGX is an effective treatment for MGD, and neurotrophism could be one of the mechanisms of IPL.
Highlights
Dry eye disease (DED) is a multifactorial disease of the ocular surface that is characterized by a loss of homeostasis of the tear film and is accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities all play etiological roles [1]. e ocular surface symptoms include dryness, pain, burning sensation, foreign body sensation, and blurred vision
Patients were recruited from the Department of Ophthalmology at Peking University ird Hospital between November 2018 and July 2019. e inclusion criteria for this study were as follows: (1) age >18 years; (2) Fitzpatrick skin types I–IV; (3) at least one symptom including dryness, pain, burning sensation, foreign body sensation, or blurred vision as well as an Ocular Surface Disease Index (OSDI) > 12; (4) clinical signs of meibomian expressibility ≥1 or ocular surface staining; (5) willingness to comply with the treatment and follow-up schedule in this study
Corneal Nerves and Intense pulsed light (IPL) Treatment. e in vivo confocal microscopy (IVCM) was applied to assess the effect of IPL treatment on corneal nerves
Summary
Dry eye disease (DED) is a multifactorial disease of the ocular surface that is characterized by a loss of homeostasis of the tear film and is accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities all play etiological roles [1]. e ocular surface symptoms include dryness, pain, burning sensation, foreign body sensation, and blurred vision. Dry eye disease (DED) is a multifactorial disease of the ocular surface that is characterized by a loss of homeostasis of the tear film and is accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities all play etiological roles [1]. Treatment for MGD depends on the clinical symptoms and signs. In 2002, it was found incidentally that dry eye symptoms significantly improved in patients with rosacea treated with IPL [5]. Several studies have investigated the effect of IPL on treating MGD [6,7,8,9,10,11,12,13,14,15,16,17,18,19,20] and demonstrated a significant improvement in both symptoms and signs
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