Comparison of Intense Pulsed Light Therapy on Patients with Meibomian Gland Dysfunction Using AQUA CEL and M22 Devices

Long-Term Impacts of Intense Pulsed Light Therapy on Ocular Surface Health and Tear Film Dynamics in Patients with Dry Eye Disease: Detailed Analysis and Observations Over a 1-Year Follow-Up Period

INTRODUCTION

To evaluate the long-term effects of intense pulsed light (IPL) therapy on patients with dry eye disease (DED) associated with meibomian gland dysfunction (MGD).

METHODS

A retrospective case series was performed with 110 participants undergoing IPL therapy. Assessments included the eye fitness test (EFT) to gauge subjective symptoms, along with objective measures using the Tearcheck® device (ESW Vision, Houdan, France) noninvasive first breakup time (NIFBUT), noninvasive average breakup time (NIABUT), central tear meniscus height (CTMH), thinnest tear meniscus height (TTMH), and ocular surface inflammatory risk evaluation (OSIE) assessed using the SCHWIND SIRIUS device (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany).

RESULTS

This study documented significant improvements in subjective and objective symptoms associated with DED and MGD. Subjective symptoms measured by the EFT showed an average increase of 9.74 points (range -10 to 28, standard deviation [SD] ± 7.54), indicating reduced symptoms. Objective measures of tear film stability, represented by NIABUT, increased by an average of 4.04 s (range -15.00 to 14.40, SD ± 4.91). Tear film stability evaluation (TFSE) scores decreased by 229.12 points on average (range -1775 to 528, SD ± 384.94), suggesting enhanced tear film stability. OSIE type 1 showed a reduction in inflammation, with a percentage decrease of 4.98% (range -45 to 5, SD ± 7.33). Additionally, OSIE capture time decreased by 3.25 s on average (range -27 to 22, SD ± 10.35), further indicating an improvement in ocular surface health.

CONCLUSION

IPL therapy was shown to be a promising, noninvasive approach for improving quality of life in patients with DED by effectively managing symptoms and stabilizing tear film. The findings support the use of IPL as a sustainable treatment modality for DED associated with MGD.

A Review of Applications and Intracellular Mechanisms of Intense Pulsed Light in Eyelid Inflammatory Diseases

Objective: To evaluate relevant clinical outcomes and conclude possible mechanisms of intense pulsed light (IPL) in eyelid inflammation. Background: IPL devices were primarily applied in cutaneous vascular malformations and have been used in ocular diseases for about 20 years, mostly including meibomian gland dysfunction (MGD), blepharitis, and ocular rosacea. Recent findings: Seventy-two original clinical researches were included, 57 for MGD, 4 for blepharitis or blepharitis-related keratoconjunctivitis, and 11 for rosacea. Dry eye symptoms, (tear) break-up time (BUT), and meibomian structure and/or functions were improved in most patients, but production of reactive oxygen species is an important link in the photobiomodulation mediated by IPL, which can influence numerous signal pathways to achieve anti-inflammatory, anti-infective, and prodifferentiation effects. Conclusions: The evidence suggests that IPL is an effective therapeutic tool for most patients with MGD, but more clinical evidence is needed for other indications.

Different Number of Sessions of Intense Pulsed Light and Meibomian Gland Expression Combination Therapy for Meibomian Gland Dysfunction

PURPOSE

To evaluate the effect of the intense pulsed light (IPL) and meibomian gland (MG) expression (MGX) combination therapy according to the total numbers of sessions in the meibomian gland dysfunction (MGD).

METHODS

Ninety patients with MGD were included. Patients had maximal five sessions of IPL (Aqua Cel, Jeisys Medical) and MGX combination therapy at 2-week intervals. The ocular surface disease index (OSDI) questionnaire score, MG profile grades, tear matrix metalloproteinase-9 (MMP-9), tear break-up time (BUT), tear osmolarity, tear secretion, and corneal erosions were evaluated.

RESULTS

The number of patients who had a total of one to five sessions (1S to 5S) was 10, 25, 17, 20, and 18, respectively. The time-serial decrease of OSDI scores was significant in patients who had three or more sessions (3S, p = 0.002; 4S, p < 0.001; 5S, p < 0.001). The MG expressibility grade decreased with two or more sessions (2S-5S, p < 0.001), but the meibum quality significantly improved with all sessions (1S, p = 0.012; 2S, p = 0.024; 3S, p = 0.015; 4S, p < 0.001; 5S, p < 0.001). Although tear BUT increased even in patients with one session (1S, p = 0.040; 3S, p = 0.005; 4S, p = 0.006; 5S, p = 0.021), tear MMP-9, osmolarity, Schirmer I, and corneal erosions were not improved in every number of sessions. The female sex was the sole contributor to the final symptomatic improvement (p = 0.042), and the MGD stages were not related to the final OSDI decrease.

CONCLUSIONS

The OSDI score, MGD grades, and BUT were improved after the IPL and MGX combination therapy in MGD patients. Unlike MGD grades and tear film instability might be improved just after a few sessions, the overall subjective relief was accomplished in three or more sessions.