Changes in the expression of matrix metalloproteinase-9 after intense pulsed light therapy combined with meibomian gland expression in moderate and severe meibomian gland dysfunction

Lee, Hun; Han, Ye Eun; Park, So Young; Lee, Jae Hyuck; Chung, Ho Seok; Moon, Su Young; Kim, Jae Yong; Tchah, Hungwon

doi:10.1016/j.clae.2020.05.008

Cited by 19 publications

(14 citation statements)

References 41 publications

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“…No significant ocular or dermatologic adverse events were recorded. IPL treatment has emerged as an alternative treatment for MGD because of its long-term clinical efficacy when compared with conventional treatments [ 11 , 12 , 14 , 17 , 20 , 28 ]. The IPL device itself generates a wide spectrum of light energy, and most chromophores, including hemoglobin, melanin, and water, absorb broad spectrum wavelengths.…”

Section: Discussionmentioning

confidence: 99%

“…After exposure of the lower eyelid margin, the IPL probe was applied in a slightly downward position with tractional force on the lower eyelid to increase the contact surface between the probe and the lid margin [ 20 ]. Patients received up to 13 light pulses with a slightly overlapping area of application, from the left preauricular area, across the cheeks and nose, to the right preauricular area [ 17 , 23 ]. For the upper lid IPL treatment, a metal spatula was carefully placed into the upper conjunctival fornix and slightly tented to minimize ocular damage.…”

Section: Methodsmentioning

confidence: 99%

“…Across the grading scale, we applied semi-quantitative interpretations of the ocular surface inflammation severity. Because of the proportional increases in MMP-9 concentrations with signal strength, the more vivid the color in the red zone, the higher the MMP-9 levels (0 = none; 1 = trace; 2 = weak positive; 3 = positive; and 4 = strong positive) [ 17 , 20 ]. The eye with a more severe MG grade was used for the MMP-9 measurement.…”

Section: Methodsmentioning

confidence: 99%

“…Sequential examination of the clinical signs was carried out following the same order in every patient: first with the MMP-9 InflammaDry immunoassay, then Schirmer’s test I, TBUT, the ocular staining scores in the cornea and conjunctiva with fluorescein, and finally, an examination of the lid margins and MG. After completing sequential physical examinations, patients responded to a questionnaire about their ocular irritation symptoms [ 17 , 20 ]. At each visit, the best spectacle-corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured.…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, a need for alternative treatments has emerged, especially treatments with good long-term effects on clinical MGD outcomes. Intense pulsed light (IPL) treatment is a well-known and effective treatment modality, even for refractory-type MGD [ 13 , 14 , 15 , 16 , 17 ]. IPL is a noncoherent polychromatic light source with a wavelength range of 400–1200 nm [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Investigation of Prognostic Factors for Intense Pulsed Light Treatment with a Vascular Filter in Patients with Moderate or Severe Meibomian Gland Dysfunction

Lee

Jang

Nam

et al. 2022

JCM

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We aimed to investigate the prognostic factors for, and treatment efficacy of, intense pulsed light (IPL) treatment with a vascular filter in patients with moderate or severe meibomian gland dysfunction (MGD). In this retrospective observational study, 58 moderate or severe MGD patients who underwent IPL treatment with a vascular filter were enrolled. IPL treatment was administered to the upper and lower eyelids four times at two-week intervals. At baseline, and four weeks after IPL, we evaluated the matrix metalloproteinase (MMP)-9 expression levels, tear break-up times (TBUT), ocular surface staining scores, lid margin telangiectasias, and meibomian gland characteristics. The subjective symptoms and adverse effects were reviewed and recorded. Regression analyses were performed to explore the prognostic factors affecting clinical outcomes. IPL treatment using a vascular filter led to improvements in the TBUT, ocular surface staining score, meibomian gland grade, meibum quality and consistency, lid margin telangiectasia, and symptom score (all p < 0.001). Furthermore, the positivity rate (90.2% to 70.6%, p = 0.013) and expression levels (1.92 ± 1.18 to 1.24 ± 1.18, p < 0.001) of tear MMP-9 improved after the IPL treatment. In multivariate logistic regression analysis, a young age (odds ratio = 0.867, p = 0.007) and a toothpaste-like consistency in the upper lid (odds ratio = 8.449, p = 0.046) were associated with improvements in the meibomian gland grade. No adverse effects were detected. IPL with a vascular filter is a safe and effective treatment for moderate and severe MGD. Age and the meibum consistency in the upper lid are important prognostic factors.

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