Intense pulsed light improves signs and symptoms of dry eye disease due to meibomian gland dysfunction: A randomized controlled study

• Published in: PloS one 2022-06, Vol.17 (6), p.e0270268-e0270268
• Main Authors: Toyos, Rolando, Desai, Neel R, Toyos, Melissa, Dell, Steven J
• Format: Article
• Language: English
• Subjects: Adverse events; Biology and Life Sciences; Complications and side effects; Diagnosis; Dry eye syndromes; Eye; Eye diseases; Eye protection; Eyelid; Fluorescein; Glands; Hypotheses; Intervals; Medicine and Health Sciences; Ophthalmic drugs; Pain; Patient outcomes; Patients; Physical Sciences; Questionnaires; Research and Analysis Methods; Rosacea; Signs and symptoms; Skin diseases; Standard error; Statistical analysis; Tears
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0270268

To compare the safety and efficacy of intense pulsed light (IPL) followed by meibomian gland expression (MGX), against monotherapy of MGX. TBUT increased from 3.8±0.2 ([mu]±standard error of mean (SEM)) to 4.5±0.3 seconds in the control arm, and from 4.0±0.2 to 6.0±0.3 in the study arm. The difference between arms was statistically significant (P < .01). Other signs/symptoms which improved in both arms but were greater in the study arm included MGS (P < .001), EDS (P < .01), the number of expressible glands in the lower eyelids (P < .0001) and upper eyelid (P < .0001), the predominant meibum quality in the lower eyelid (P < .0001) and upper eyelid (P < .0001), and the level of pain due to MGX (P < .0001). Outcome measures which improved in both arms with no significant differences between the two were OSDI (P = .9984), and the daily use of artificial tears (P = .8216). Meibography, daily use of warm compresses, and severity of skin rosacea did not show statistically significant changes in either arm. No serious adverse events were observed. There was a slight tendency for more adverse events in the control group (P = 0.06). The results of this study suggest that, in patients with moderate to severe symptoms, combination therapy of intense pulse light (IPL) and meibomian gland expression (MGX) could be a safe and useful approach for improving signs of dry eye disease (DED) due to meibomian gland dysfunction (MGD). Future studies are needed to elucidate if and how such improvements can be generalized to different severity levels of MGD.