Pulsed Light Treatment Improves Optical Quality, MGD Signs and Symptoms

Pulsed light treatment combined with meibomian gland expression can improve both optical quality and clinical signs and symptoms of meibomian gland dysfunction (MGD), according to a study published in BMC Ophthalmology.

Researchers retrospectively reviewed data from 45 patients with MGD (mean age 52.3 years; 53.3% women) who received pulsed light treatment 4 times at 3-week intervals between March and December of 2021. Study participants underwent visual acuity, tear breakup time (TBUT), Schirmer 1, and Ocular Surface Disease Index (OSDI) assessments at baseline and study completion. The investigators examined optical quality using an optical quality analysis system.

The intense pulsed light treatment plus meibomian gland expression resulted in significant improvements to all optical quality parameters, which included Strehl ratio, modulation transfer function cutoff, and objective scatter index (P <.001 for all). MGD signs and symptoms improved as well, evidenced by significant improvements in TBUT, meibomian gland expressibility, Schirmer 1 test scores, OSDI scores, and conjunctival staining scores (P <.001 for all).

Visual acuity improved from baseline to the study conclusion (0.04 vs 0.03 logarithm of the minimum angle of resolution [logMAR]) and trended toward statistical significance (P =.08). Mean and maximum lipid layer thickness also increased significantly from baseline (P =.031 and P =.021, respectively). Minimum lipid layer thickness values increased as well, but these increases did not attain statistical significance (5.74 nm increase; P =.207). The team also noted a significantly lower partial blinking rate following intense pulsed light treatment plus meibomian gland expression compared with baseline (0.51 vs 0.39; P =.037).

“[Intense pulsed light] can heal the [meibomian gland], enabling it to produce good quality meibum,” according to the study authors. “It is expected that [intense pulsed light] treatment will play a positive role in maintaining the tear film and improving [visual acuity] and clinical outcomes in patients with MGD.”

Study limitations include an uncontrolled design, small sample size, short study duration, and potential confounding due to the use of artificial tears.