Low Level Light Therapy as an Adjunct Treatment for Meibomian Gland Dysfunction

Abstract

Importance: This study highlights the adjunctive value of low-level light therapy (LLLT) in the management of meibomian gland dysfunction (MGD). Background: To evaluate the effects of LLLT treatment on clinical measures of dry eye related to MGD in patients unresponsive to previous therapies. Design: A retrospective chart review of patients treated at one site. Participants: Fifty eyes of 25 treated patients who were documented treatment failures with previous pharmaceuticals and/or devices were evaluated. Methods: LLLT treatment consisted of 3 treatments in one week, with adjunct use of a topical steroid/antibiotic combination. The post-treatment diagnostic measures had to have been made 3 to 5 weeks after the last LLLT treatment. Main Outcome Measures: Results included changes in the graded MGD score (grading scale 0-4), tear breakup time (TBUT), an Ocular Surface Disease Index (OSDI) questionnaire score and lissamine green (LG) staining. Results: Significant improvements in the mean OSDI score (p = 0.002), MGD grading (p < 0.001), TBUT (p < 0.001) and both nasal and temporal LG staining (p < 0.02) were observed after treatment. An MGD grade reduction of 1 or more was observed in 72% of eyes (36/50), and 2 or more in 32% of eyes (16/50). There were no ocular or facial adverse events or side effects related to the treatment. Conclusion: The application of LLLT over a short series of sessions for the treatment of MGD appeared to be beneficial in the majority of patients who had failed to improve with alternative pharmaceutical and device interventions.

Combined Intense Pulsed Light and Low-Level Light Therapy for the Treatment of Dry Eye: A Retrospective Before–After Study with One-Year Follow-Up

“…The study design does not allow to discriminate the differential effect of IPL and LLLT, a necessary aim since the effectiveness of the latter is currently supported by very limited evidence. We are only aware of two small studies that applied LLLT alone in patients with DED, obtaining significant improvements in the OSDI, 17 TBUT 16,17 and MGD 17 after 1-3 months. Regarding IPL, although there are several published case series, 13 the strongest evidence on its efficacy comes from some sham-controlled [10][11][12]24 and non-masked comparative 14,27 randomized trials.…”

“…This technique uses light-emitting diodes (LEDs) at wavelengths insufficient to produce a thermal effect (often 590–633 nm), but that increases photon intensity and its capacity to penetrate below the skin, inducing cellular photoactivation. 15 In patients with DED, Toyos et al 16 observed a significant increase in Tear film Breakup Time (TBUT) after 3 months of red-light treatment, and Stonecipher et al 17 obtained significant improvements in symptoms, TBUT and MGD after 3 sessions over one week.…”

Current treatments for Meibomian Gland Dysfunction and Eye Lid Margin Disease

“…Stonecipher., et al showed in a 15-minute session of LLLT used 3 times in one week in dry eye patients who had failed previous pharmacologic, therapeutic, or combination treatments the significant improvements in TBUT (p < 0.001), lissamine green staining (p < 0.02), and MGD grading (p < 0.001) in 3 -5 weeks. In addition to objective findings, subjective improvements in OSDI scores (p = 0.002) were also seen [22].…”

Safety and Efficacy of BroadBand Intense Pulsed Light Therapy for Dry Eye Disease with Meibomian Gland Dysfunction

“…24 Interestingly, some recent photobiomodulation modalities, such as lowlevel light therapy (LLT), which involves athermal photoactivation, have also been shown to improve dry eye symptoms, tear breakup times, and meibomian gland structure with minimal side effects. 41,42 Future research can compare the effects of BBL-IPL with other athermal treatment modalities like LLT on the improvement of DED from MGD.…”

“…Figure2Dry eye symptom severity according to the Canadian Dry Eye Assessment (CDEA) questionnaire before and after BBL-IPL therapy. Total scores for the CDEA questionnaire range from 0 to 48 and are interpreted as no dry eye symptoms or normal (<5), mild dry eye symptoms(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), moderate dry eye symptoms(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), or severe dry eye symptoms(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48).…”