Intense pulsed light therapy (IPL) in treatment of refractory Meibomian gland dysfunction (MGD)

Purpose: This was a prospective study to evaluate the efficacy and safety of Intense pulsed light therapy(IPL) using(E-Eye; E-SWIN, Paris, France) in meibomian gland dysfunction patients(MGD).
Patients and methods: The study included adult patients >18years with uncontrolled MGD based on symptoms of dry eye disease(DED), Ocular Surface Disease Index score(OSDI) ≥13and slit-lamp evidence of MGD. Symptoms evaluation using OSDI, best corrected visual acuity (BCVA), intraocular pressure (IOP), conjunctival injection, lower tear meniscus height (TMH), tear break-up time(TBUT), corneal staining, lid margin and meibomian gland assessments, noncontact Sirius meibography were evaluated pretreatment and 4weeks after the final session of treatment.
Results: There was a significant improvement in symptoms based on OSDI changes(p<0.001), a significant decrease in conjunctival injection and a significant increase in TBUT from3.8+1.1 seconds to 6.5+1.08seconds. The Oxford corneal staining scale reduced significantly after IPL(p<0.001).TMH did not show a statistical improvement at the end of follow up period(p=0.2). Compared to baseline, rounding of posterior lid margin, irregularity, and vascularity were significantly improved after the treatments, while anterior blepharitis did not show statistical improvement. Both meibomian gland secretion quality and expressibility showed a significant improvement at the end of follow up period(p<0.001). Sirius meibography results after IPL showed a statistically significant improvement in both meiboscore and MG loss in both upper lid(UL) and lower lid (LL)(p<0.001). There were no signs of skin blistering, swelling, redness, or depigmentation.
Conclusion: Intense pulsed light (IPL) using (E-Eye, E-Swin) is a safe and potentially effective treatment option in alleviating symptoms and signs of MGD.