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Dry Eye

Intense pulsed light, meibomian gland expression combo shows promise in treating DED

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The combination of intense pulsed light (IPL) therapy on the upper and lower eyelids with meibomian gland expression (MGX) appears to be a safe and effective treatment option for Meibomian gland dysfunction (MGD)-related dry eye disease, according to a study.

The study involved 160 patients (320 eyes) who exhibited ocular discomfort and signs of MGD, as determined by an Ocular Surface Disease Index (OSDI) score above 13.

Baseline testing included visual acuity (VA), intraocular pressure, Schirmer test, meibography, non-invasive tear breakup time (NITBUT), slit-lamp examination (corneal and conjunctival staining, hyperemia, gland expressibility, and meibum quality), tear osmolarity, and lipid layer thickness.

Treatment consisted of 4 sessions of IPL, performed on the upper and lower eyelids of both eyes, with a focus on the inferior eyelid for MGX. These sessions were spaced 2 weeks apart. Four weeks after the final treatment session, all patients were reevaluated.

Significant improvements were observed in various parameters, including VA, OSDI scores, tear osmolarity, lipid layer thickness, NITBUT, hyperemia, corneal and conjunctival staining, gland expressibility, meibum quality, inferior eyelid Meiboscore, and Schirmer test values. These improvements were statistically significant (P < 0.027).

The study found that the extent of improvement in OSDI scores and average NITBUT was greater in patients with more severe dry eye disease, as indicated by higher initial OSDI scores. In addition, patients with increased pre-treatment OSDI scores, hyperemia, corneal and conjunctival staining, and Schirmer test values experienced greater improvements in OSDI scores (P < 0.040).

No adverse events related to the IPL and MGX treatment were reported.

Reference
Benitez-Del-Castillo JM, López-Pérez MD, Cano-Ortiz A, et al. Efficacy and safety of intense pulsed light of upper and lower eyelids in Meibomian gland dysfunction: A prospective multicentric study. Eur J Ophthalmol. 2023 Sep 6:11206721231199121. doi: 10.1177/11206721231199121. Epub ahead of print. PMID: 37671407.

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