Intense pulsed light treatment of the upper and lower eyelids in patients with moderate-to-severe meibomian gland dysfunction

Chung, Ho Seok; Han, Ye Eun; Lee, Hun; Kim, Jae Yong; Tchah, Hungwon

doi:10.1007/s10792-022-02389-0

Cited by 9 publications

(19 citation statements)

References 39 publications

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“…Seven studies did not report on the occurrence of adverse events, six studies reported no adverse events while three studies found non‐serious adverse events such as conjunctival abrasion, self‐limiting eyelash thinning, self‐limiting hyper‐pigmentation, gritty sensation, discharge burning and redness (Chung, Rhim, & Park, 2022; Rong, Tang, Tu, et al, 2018; Zhang‐Nunes et al, 2021). Two of the studies explored whether treatment of the upper eyelid in addition to the lower eyelid would increase the treatment efficacy: one was prospective and randomised (Li et al, 2020) while the other was retrospective (Chung, Han, et al, 2022). Both studies described an additive effect of upper eyelid treatment.…”

Section: Resultsmentioning

confidence: 99%

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Intense pulsed light treatment in meibomian gland dysfunction: Past, present, and future

Fineide,

Magnø,

Khan

et al. 2023

Acta Ophthalmologica

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Dry eye disease is a highly prevalent condition, which can substantially impair quality of life, work productivity, and vision. It is considered an inflammatory disease and the most common cause is meibomian gland dysfunction. Despite many treatment alternatives being available, including artificial tears, warm compresses, antibiotics, and anti‐inflammatory therapy, lasting treatment effects are rare. Over the last two decades, intense pulsed light therapy, after being well established in dermatology, has been gradually introduced to the field of ophthalmology to treat meibomian gland dysfunction. The purpose of the current article is to critically review the clinical studies assessing the use of intense pulsed light to treat meibomian gland dysfunction published to date. The vast majority of the included studies demonstrated improved symptoms and signs, although the degree of efficacy and its duration varied greatly depending on concomitant treatment, number of treatment sessions, and other factors. Several possible mechanisms of action concerning disease propagation and treatment efficacy are discussed. There is still a need for larger, randomised, longitudinal studies to define the most efficacious treatment regime and to predict which patients may benefit the most. More studies are needed on implementing biochemical analyses and machine learning algorithms. Such studies may prove beneficial in predicting treatment effects, defining optimal treatment regimens, and furthering our understanding of the mechanisms of action.

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Section: Resultsmentioning

confidence: 99%

“…,IL-10 (Choi et al, 2019), IL-17A(Choi et al, 2019;Gao et al, 2019;Liu et al, 2017), IL-17F (D'Souza et al, 2021), IL-18 (D'Souza et al, 2021), MMP-9(Chung, Han, et al, 2022; D'Souza et al, 2021;Han et al, 2022;Lee et al, 2021), PG-E2(Liu et al, 2017), TNFα (Choi…”

mentioning

confidence: 99%

Intense pulsed light treatment in meibomian gland dysfunction: Past, present, and future

Fineide,

Magnø,

Khan

et al. 2023

Acta Ophthalmologica

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“…Before the treatment sessions, every patient underwent Fitzpatrick skin typing, and adjustment of the IPL system was performed for a specific setting. All patients enrolled had Fitzpatrick skin type 3 32 , 41 , 45 . Clinical parameters for MGD signs were recorded via slit lamp examination before IPL treatment and 4 weeks after four sessions of IPL treatment.…”

Section: Methodsmentioning

confidence: 99%

“…Because of proportional increases in MMP-9 concentration with signal strength, a more vivid color in the red zone indicates higher MMP-9 levels (0 = none; 1 = trace; 2 = weak positive; 3 = positive; and 4 = strong positive) 49 . When determining the positivity of MMP-9, positive MMP-9 (MMP-9 ≥ 40 ng/mL) was defined as including weak positive, positive, and strong positive, and negative MMP-9 (MMP-9 < 40 ng/mL) was defined as including trace positive and negative 45 . All patients completed an OSDI before and 4-weeks after IPL sessions to report clinical symptoms.…”

Section: Methodsmentioning

confidence: 99%

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

Jang

Lee

Nam

et al. 2023

Sci Rep

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Our study compared treatment efficacy between cut-off and notch filters in intense pulsed light (IPL) therapy for meibomian gland dysfunction (MGD) through a prospective, randomized paired-eye trial. Additionally, the efficacy of IPL treatment alone was investigated by restricting other conventional treatments. One eye was randomly selected for an acne filter and the other for a 590-nm filter. Identical four regimens of IPL treatments were administered. The tear break-up time (TBUT), Oxford scale, Sjögren’s International Clinical Collaborative Alliance (SICCA) staining score, tear matrix metalloproteinase-9 (MMP-9) expression, tear osmolarity, and Ocular Surface Disease Index (OSDI) questionnaires were evaluated before and after IPL. Meibomian gland (MG) parameters were measured. When combining the results from both filters, the TBUT, SICCA staining score, OSDI score, and upper and lower lid meibum expressibility were improved after IPL. No significant differences were found between the two filters in the TBUT, Oxford scale, SICCA staining score, MMP-9 expression, tear osmolarity, and MG parameters. Although not significant, the acne filter showed better treatment efficacy than that in the 590-nm filter. IPL alone is efficacious in terms of ocular surface parameters, MG function, and subjective symptoms. Regarding filter selection, both acne and 590-nm filters are promising options for MGD treatment.

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“…In recent years, intense pulsed light (IPL) treatment has emerged as a useful treatment option for DED with MGD [ 12 – 15 ]. Numerous studies have documented significant improvements in parameters such as the ocular surface disease index (OSDI) score, corneal and conjunctival staining (CFS) score, Schirmer test value, meibomian gland expressibility (MGE), and tear break-up time (TBUT) following IPL treatment [ 15 – 19 ]. Additionally, improved subjective visual acuity (VA) and the quality of vision after IPL treatment has been reported in patients with DED [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Intense pulsed-light treatment improves objective optical quality in patients with meibomian gland dysfunction

2023

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Background To evaluate changes in objective optical quality following intense pulsed light (IPL) treatment combined with meibomian gland (MG) expression (MGX) in patients with MG dysfunction (MGD). Methods This retrospective cross-sectional study included MGD-related dry eye disease (DED) patients who received IPL treatment between March and December 2021 at Kim’s Eye Hospital, Seoul, Republic of Korea. Each patient underwent four sessions of IPL treatment using Lumenis M22 (Lumenis Ltd., Yokneam, Israel) and MGX at three-week intervals. Results This study included 90 eyes from 45 patients with MGD. The mean age was 52.3 ± 16.1 years (range, 20–75 years), and 53.3% (24/45) of patients were female. Compared with the baseline, all clinical symptoms and signs significantly improved after IPL treatment combined with MGX. All optical quality parameters obtained with an optical quality analysis system (OQAS: Visiometrics, Castelldefels, Spain) have improved significantly over the baseline (p < 0.001). Conclusions In patients with MGD, IPL treatment combined with MGX improved the objective optical quality and clinical signs and symptoms of DED.

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Intense pulsed light treatment of the upper and lower eyelids in patients with moderate-to-severe meibomian gland dysfunction

Cited by 9 publications

References 39 publications

Intense pulsed light treatment in meibomian gland dysfunction: Past, present, and future

Intense pulsed light treatment in meibomian gland dysfunction: Past, present, and future

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

Intense pulsed-light treatment improves objective optical quality in patients with meibomian gland dysfunction

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