Combined IPL, Home-Based Therapies Effective Against Meibomian Gland Dysfunction

Intense pulsed light (IPL) therapy combined with conventional home-based therapy can effectively help manage meibomian gland dysfunction (MGD), according to a study published in Clinical and Experimental Optometry. Home-based therapies alone also provided effective treatment, according to the study.   

MGD is the main cause of evaporative dry eye disease. Current treatments include topical anti-inflammatory and antibacterial agents, artificial tear supplementation, warm compress therapy, meibomian gland expression, dietary omega-3 oil supplementation, and eyelid hygiene. Recently, optometrists have added therapies such as thermal pulsation, wet chamber latent heat application, and IPL to their treatment toolbox.

The study aimed to assess the efficacy of a novel 5-flash IPL technique combined with home-based therapy and compare it with conventional home care alone in patients with MGD. A total of 100 symptomatic patients with MGD were enrolled in a randomized controlled trial. The treatment group underwent 3 sessions of 5-flash IPL therapy. Eyelid warming, lid hygiene, and lubricant therapy were prescribed for all participants. 

Investigators found that Ocular Surface Disease Index (OSDI), noninvasive keratograph tear break up time (NIK-TBUT), fluorescein TBUT, MG expressibility, meibum quality, and tear osmolarity were improved at follow up visits in both groups (P <.05). On day 75, they found that NIKBUT was significantly higher in the IPL group (P =.045). The IPL treatment effect was not statistically significant (P >.05), except for bulbar and limbal hyperemia (P =.02 and P =.02, respectively). In both groups, younger patients showed more improvement in NIK-TBUT (P =.02, r=-0.32; P <.001, r=-0.52).

The study’s authors note some limitations to their work, including that meibomian gland expression was not used in this study. Instead, eyelid massage, lid scrub, and squeezing were recommended for both groups, and the techniques were demonstrated to the patients. Second, they did not measure compliance with home-based treatment recommendations. Third, most of the patients had moderate cases of MGD. Lastly, using a placebo/sham and performing contralateral eye studies might provide more useful data.

Reference

Zarei-Ghanavati S, Hassanzadeh S, Azimi Khorasani A, et al. Efficacy of five-flash intense pulsed light therapy technique in patients with meibomian gland dysfunction. Clin Exp Optom. Published online September 19, 2021. doi:10.1080/08164622.2021.1976595