Treatment of dry eye disease due to meibomian gland dysfunction using intense pulsed light and low-level light therapy

Abstract

Background Meibomian gland dysfunction (MGD) is an abnormal chronic state of meibomian glands in which there is quality and quantity alternations in the meibum glandular secretion or terminal duct obstruction. Patients with MGD show imbalance in the tear film components because of the lipid layer deficiency.Objectives The aim of this study was to assess the changes in the tear film after using intense pulsed light and low-level light therapy (IPL-LLLT) according to the Dry Eye Workshop classification.Patients and methods The study enrolled 80 eyes of 40 patients of both sexes with dry eye disease caused by MGD, with age range from 23 to 74 years. They showed symptoms of unilateral or bilateral dryness, diagnosed as MGD, with a meibum grade more than or equal to 1 and with a Fitzpatrick skin type of two to five appearance dependent and sensitivities to sun light. They were studied by comparing the pretreatment and posttreatment session values.Results The Dry Eye Workshop score showed a significant reduction after 4 weeks of the IPL-LLLT treatment in comparison with the baseline (P<0.001). The meibomian gland evaluation scores (meibum grade and meiboscale) showed a significant improvement after 4 weeks of treatment (P<0.001). Moreover, the Standard Patient Evaluation of Eye Dryness significantly decreased after the treatment (P<0.001). No undesirable events were observed except for four cases, all of which showed transient redness. In addition, one patient showed an obvious improvement in Schirmer test I, the second showed deterioration in the meibum grade, and the third showed deterioration in visual acuity, Schirmer test I, tear break-up time, corneal fluorescein staining, meibum grade, and Standard Patient Evaluation of Eye Dryness.Conclusions IPL-LLLT combination could be used as a safe and efficient way for MGD treatment. However, it does not completely cure the MGD.