scholarly journals Therapeutic Effect of Intense Pulsed Light (IPL) Combined with Meibomian Gland Expression (MGX) on Meibomian Gland Dysfunction (MGD)

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Shanshan Wei ◽  
Xiaotong Ren ◽  
Yuexin Wang ◽  
Yilin Chou ◽  
Xuemin Li
Keyword(s):  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Pulsed Light ◽  
Ocular Surface Disease Index ◽  
Eyelid Margin ◽  
Assessment Scores ◽  
Before And After ◽  
Corneal Nerve

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.

scholarly journals Factors Influencing the Effectiveness of Intense Pulsed Light for Meibomian Gland Dysfunction

2020 ◽  
Author(s):  
Chen Chen ◽  
Di Chen ◽  
Yu-yu Chou ◽  
qin long
Keyword(s):  
Influencing Factors ◽  
Clinical Symptoms ◽  
Influencing Factor ◽  
Univariate Analysis ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Pulsed Light ◽  
Ocular Surface Disease Index ◽  
Eyelid Margin

Abstract Purpose: To observe the effectiveness of intense pulsed light (IPL) for meibomian gland dysfunction (MGD) and identify its influencing factors. Methods: Forty-eight eyes of 48 patients with MGD were included. Subjects were followed up 5 times and received IPL during the first three visits. Gender, age, duration of MGD, time of video display terminal usage, and severity of MGD were recorded at baseline. At every visit, Ocular Surface Disease Index (OSDI), eyelid margin abnormality score (EMAS), tear film breakup time (TBUT), Schirmer Ⅰ test (SⅠt) and corneal fluorescein staining (CFS) were recorded. The clinical parameters before and after 3 IPL treatments were compared. Univariate and multivariable logistic regression analyses were performed to explore influencing factors. Results: Compared with baseline, the TBUT was increased and the CFS score and OSDI were significantly decreased on day 45 and day 120 (all P < 0.001). In univariate analysis, among the patients with a younger age (18-39 years), moderate MGD, higher baseline SIt and higher baseline OSDI, the IPL treatment had a higher effective rate (P = 0.032, 0.004, 0.024 and 0.014 respectively). The MGD severity was strongly associated with effective IPL, and patients with moderate MGD had an OR of 5.493 compared with the severe MGD patients (OR = 22.454, 95% CI: 2.890-174.436, P = 0.003). Conclusions: IPL effectively improves clinical symptoms and some signs in MGD patients. Age, MGD severity, baseline SIt and baseline OSDI are potential factors that may influence the effectiveness of IPL. MGD severity is an independent influencing factor.

scholarly journals Intense pulsed light plus meibomian gland expression versus intense pulsed light alone for meibomian gland dysfunction: A randomized crossover study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0246245
Author(s):  
Kyoung Yoon Shin ◽  
Dong Hui Lim ◽  
Chan Hee Moon ◽  
Byung Jin Kim ◽  
Tae-Young Chung
Keyword(s):  
Meibomian Gland ◽  
Treatment Session ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
P Value ◽  
Pulsed Light ◽  
Ocular Surface Disease Index ◽  
P Values ◽  
Group 2 ◽  
Group 1

Purpose To investigate the comparative efficacy of intense pulsed light (IPL) therapy alone with that of IPL plus meibomian gland expression (MGX) for meibomian gland dysfunction (MGD). Methods This is a prospective randomized crossover clinical trial. Sixty patients were enrolled and randomly assigned to two groups. All of patients underwent four treatment sessions in total, which were two weeks apart. Group 1 underwent two sessions of IPL therapy with MGX, as well as two sessions of IPL alone. Group 2 received two sessions of IPL therapy alone, and two sessions of IPL therapy with MGX. The following parameters were measured at baseline (BL), 2 weeks after the second treatment session (FU1), and 2 weeks after the fourth treatment session (FU2): tearfilm break-up time (BUT), Oxford grade for corneal staining, meibomian gland expressibility (MGE), meibum quality (MQ), and ocular surface disease index (OSDI). The separate effect of MGX on improvement of MGD parameters was evaluated using generalized estimating equation (GEE). Results The mean age of the participants was 57.52 ± 10.50 years. The BUT, Oxford grade, MGE, MQ, and OSDI of both groups improved significantly (from baseline) by the end of four treatment sessions (FU2 compared to BL; all p-values <0.05). The MGE and MQ significantly improved after the first and second treatment sessions (FU1 compare to BL; all p-values < 0.001). However, the improvement was not statistically significant after the third and fourth treatment sessions (FU2 compared to FU1; p-value of 0.388 for MGE and 0.645 for MQ in group 1, 0.333 for MGE and 0.333 for MQ in group 2). The IPL plus MGX therapy produced greater improvements in the BUT scores than did IPL therapy alone (p = 0.003 by GEE). In contrast, the Oxford grade, MGE, MQ, and OSDI were not influenced by the addition of MGX to IPL (p = 0.642, 0.663, 0.731, and 0.840, respectively by GEE). Conclusion IPL therapy effectively improves the subjective symptoms and objective ocular findings of MGD. MGX enhanced the improvement of BUT driven by IPL therapy. The meibomian gland function (MGE and MQ) recovers faster in response to IPL therapy than did the other parameters.

scholarly journals Intense Pulsed Light Therapy with Optimal Pulse Technology as an Adjunct Therapy for Moderate to Severe Blepharitis-Associated Keratoconjunctivitis

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Fang Ruan ◽  
Yunxiao Zang ◽  
Ruti Sella ◽  
Hongshuang Lu ◽  
Shang Li ◽  
...  
Keyword(s):  
Treatment Group ◽  
Outcome Measures ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Pulsed Light ◽  
Ocular Surface Disease Index ◽  
Open Label ◽  
Eyelid Margin ◽  
Adjunct Therapy ◽  
Pulse Technology

Purpose. To evaluate the intense pulsed light (IPL) therapy with optimal pulse technology (OPT, M22™, Lumenis, USA) as an adjunct therapy for the prevention of recurrences in moderate to severe blepharokeratoconjunctivitis (BKC). Methods. This open-label nonrandomized clinical trial evaluated 33 patients diagnosed with BKC. Twenty-one patients received four bilateral OPT therapy sessions with Meibomian gland expression (MGX) (treatment group), and 11 patients received MGX alone (controls). This trial was initiated after a four-week pharmacotherapy for BKC in both groups and was scheduled at four-week intervals. Efficacy outcome measures included meibum quality, Meibomian gland (MG) secretion function, eyelid margin signs, corneal fluorescein staining (CFS) score, noninvasive keratography breakup time (NIKBUT), ocular surface disease index (OSDI) score, Schirmer I test (SIT), classification of tear film lipid layer (TFLL), and Meibomian gland dropout (MGDR). Safety outcome measures included visual acuity, intraocular pressure, eye structure damage, and facial skin appearance at each visit. Results. Quality of meibum, MG expressibility, eyelid margin signs, and OSDI score showed a statistically significant greater improvement in the treatment group after one to three treatment sessions, compared to controls (p<0.05). While these improved in both groups in comparison to baseline, the NIKBUT and upper and lower eyelid MGDRs significantly improved only in the treatment group (p<0.05). No adverse events occurred in both groups. No BKC recurrences were noted in the treatment group. Conclusions. IPL is a safe and effective adjuvant treatment for BKC and possibly more effective in reducing eyelid margin inflammation and prevents recurrences than MGX alone. This trial is registered with ChiCTR-ONN-17013864.

scholarly journals Characterization and Prediction of the Clinical Outcome of Intense Pulsed Light-Based Treatment in Dry Eye Associated to Meibomian Gland Dysfunction

2021 ◽  
Vol 10 (16) ◽  
pp. 3573
Author(s):  
María T. Iradier ◽  
María Ángeles del Buey ◽  
Cristina Peris-Martínez ◽  
Priscilla Cedano ◽  
David P Piñero
Keyword(s):  
Case Series ◽  
Tear Film ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Successful Outcome ◽  
Pulsed Light ◽  
Ocular Surface Disease Index ◽  
Non Invasive ◽  
Break Up

This non-comparative prospective case series was conducted to characterize the clinical impact of intense pulsed light (IPL)-based treatment in dry eyes associated to Meibomian gland dysfunction (MGD), defining the predicting factors for a successful outcome with this therapy in a large case series. A total of 390 eyes (195 patients, range: 23–93 years) received four sessions of Optima IPL system (Lumenis, Yokneam, Israel). Significant changes were observed in tear film osmolarity in both eyes (p < 0.001) and in meibum quality (p < 0.001), with more eyes showing clear or yellow secretions after therapy. Mean change in the ocular surface disease index (OSDI) was −8.61, ranging from −27.00 to 11.00. This change was significantly correlated with the baseline value of OSDI (r = −0.489, p < 0.001). The change in osmolarity correlated significantly with the baseline osmolarity in both eyes (right r = −0.636, left r = −0.620, p < 0.001). A linear predicting model of the change in OSDI with therapy was obtained: change OSDI = 10.99 − 0.35 × OSDI − 1.03 × NIBUTRE-LE (mean non-invasive break up time of right and left eye) −2.03 × Meibum quality grade (p = 0.001; R2: 0.325). In conclusion, the improvement in symptomatology achieved with an IPL-based therapy can be predicted at baseline using a linear model considering the level of MGD and the magnitude of OSDI and NIBUT (non-invasive break-up time).

scholarly journals Clinic Results of Intraductal Meibomian Gland Probing Combined Intense Pulsed Light in Treating Patients With Refractory Obstructive Meibomian Gland Dysfunction: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Xiaodan Huang ◽  
Qiyu Qin ◽  
Linping Wang ◽  
Jiao Zheng ◽  
Lin Lin ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Symptom Relief ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Pulsed Light ◽  
Group I ◽  
Final Treatment ◽  
Group Ii ◽  
Better Than

Abstract Background: To optimize therapeutic regimen for refractory obstructive meibomian gland dysfunction (o-MGD) patients by combining intraductal meibomian gland probing (MGP) and intense pulsed light (IPL) to enhance their effect and reduce their limitations. Methods: This randomized, assessor blind study include 45 patients (90 eyes) with refractory o-MGD. They were divided into 3 groups by allocation concealment: IPL (group I, received an IPL treatment course: 3 times at 3-week intervals), MGP (group II, received MGP one time) and MGP combined IPL (group III, MGP at first then an IPL treatment course). Standard Patient Evaluation of Eye Dryness score (SPEED), tear break-up time (TBUT), corneal fluorescein staining (CFS), meibum grade and lid margin finding results were assessed at baseline, 3 weeks after final treatment in group I and III, 3 and 12 weeks after MGP in group II. Six months after final treatment, the SPEED and willingness to receive any treatment again were also collected in all groups. Paired Wilcoxon, Mann-Whitney U with Bonferroni correction and Kruskal-Wallis tests were used for data analysis. Results: In 3 groups, all above indexes improved significantly after treatment (all P＜0.01). MGP-IPL was better than IPL and MPG in posttreatment SPEED, TBUT, meibum grade, lid telangiectasia (all P＜0.05/3). Besides, the MGP-IPL was better than IPL in lid tenderness and better than MGP in orifices abnormality (all P＜0.05/3 ). Six months later, the SPEED in MGP-IPL was also significantly lower than other groups (all P＜0.05/3). And no patients in MGP-IPL group revealed the need to be treated again, while 35.7% or 20% of patients with IPL or MGP need retreatment. Conclusions: Compared with single IPL or MGP, the combination of MGP and IPL demonstrated the most efficient results in relieving all signs and symptoms and can help patients attain the most lasting symptom relief. Trial registration: http://clinicaltrials.gov, ChiCTR1900021273 (retrospectively registered 09 February 2019). Funding: This work was supported by the National Natural Science Foundation of China: [grant numbers: 81870624; 81700802]; Major Science and Technology Projects of Zhejiang Province [grant numbers: 2017C03046].

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