Intense pulsed light for the treatment of Meibomian gland dysfunction: A systematic review and meta‑analysis

Abstract

Meibomian gland dysfunction (MGD) is frequently encountered by eye care practitioners. It is characterised by obstruction of the Meibomian glands and/or alterations in the consistency of glandular secretions. At present, no definitive treatment exists for this condition. The present meta-analysis was performed to assess the efficacy of intense pulsed light (IPL) therapy in the management of MGD. Databases including EMBASE, PubMed, Cochrane Central, MEDLINE and Google Scholar were systematically searched to identify clinical trials that assessed the efficacy of IPL in the treatment of MGD. Outcome measures were described as the standardized mean difference (SMD). The fixed-or random-effects model was selected for analysis based on the Cochrane I 2 values representing heterogeneity. Publication bias was visually inspected using Begg's funnel plot. Data were synthesized from four randomized controlled trials (RCTs) comprising 122 subjects in the IPL group and 120 subjects in the control group. Pooled analysis indicated no statistically significant difference in the Standard Patient Evaluation of Eye Dryness (SPEED) scores between the two groups [SMD-0.16 (95% CI,-0.41 to 0.10)] but a significant increase in Non-Invasive Tear Break-Up Time (NIBUT) scores in the IPL group (SMD, 0.90; 95% CI, 0.40-1.40). To conclude, the results of the present study did not provide any conclusive evidence for the efficacy of IPL therapy in the management of MGD. The analysis indicated that IPL therapy may result in an improvement of objective NIBUT scores but has no effect on subjective SPEED scores. Given the limited number of studies performed to date, there is a requirement for more well-designed prospective RCTs with a larger sample size to provide further evidence on the efficacy of IPL therapy.

S2k guideline: Rosacea

“…In recent years, there have been several publications on studies treating MGD diseases including ocular rosacea with intense pulsed light (IPL) [124]. These have not at this point in time led to recommendations; further studies are required.…”

Efficacy of hyaluronic acid 0.3%, cyanocobalamin, electrolytes, and P-Plus in menopause patients with moderate dry eye disease

“…Tear acts as the substitute to increase humidity at the ocular surface and improve lubrication, consequently reducing symptoms in most cases [9]. Currently, there are several strategies for the treatment of dry eyes, whereby autologous serum [10], surgical interventions [11] or combinations of lubrication and anti-inflammatory agents [12] have been used. In many cases, nutritional supplementation [13], such as that with omega-3 and omega-6 fatty acids, and temporary occlusion of the dry eye [14] are considered reasonable recommendations.…”

Comparison of clinical outcomes between intense pulsed light therapy using two different filters in meibomian gland dysfunction: Prospective randomized study

“…In several meta-analysis, TBUT and the Standard Patient Evaluation of Eye Dryness (SPEED) scores were improved after IPL treatment in patients with MGD. However, SPEED score improvement was not signi cant [32][33][34] . As shown in previous meta-analysis, the therapeutic effect of IPL on subjective symptom score is controversial 32 .We assumed that many confounding factors such as warm compression, lid scrub, and topical anti-in ammatory eyedrops could contribute to ambiguous symptomatoloy.…”

“…However, SPEED score improvement was not signi cant [32][33][34] . As shown in previous meta-analysis, the therapeutic effect of IPL on subjective symptom score is controversial 32 .We assumed that many confounding factors such as warm compression, lid scrub, and topical anti-in ammatory eyedrops could contribute to ambiguous symptomatoloy. Most previously published studies did not control for patient's self-administration of eye drops, which could be an important confounding factor 35 .…”