Meibomian Gland Dysfunction: Intense Pulsed Light Therapy in Combination with Low-Level Light Therapy as Rescue Treatment

Abstract

Background and Objectives: Evaporative dry eye disease is frequently associated with meibomian gland dysfunction. Patients are often unhappy because of daily drops, care burden, and suboptimal conventional treatments. In this study, we assessed the efficacy of a novel device, the Eye-light®, a combination of intense pulsed light therapy and low-level light therapy, as a novel treatment for meibomian gland dysfunction and dry eye disease. Materials and Methods: This was a retrospective, single-center study carried out over a 6-week period, in which 22 eyes from 11 patients were included. Each patient received four combined light therapy treatment sessions, once weekly over 4 weeks. Patients underwent a clinical examination and filled out a standardized questionnaire to evaluate symptoms one week prior to treatment, and one week after the fourth session. Results: Combined light therapy improved several ocular surface outcome measures in our patients. This study demonstrates that this adjunctive treatment significantly improves the ocular surface and quality of life of patients with dry eye disease and meibomian gland dysfunction. Conclusions: Combined light therapy may be included in meibomian gland dysfunction treatment protocols as an adjunctive rescue treatment.

Response of tear cytokines following intense pulsed light combined with meibomian gland expression for treating meibomian gland dysfunction-related dry eye

“…There has been no agreement on the periods of treatment for MGD. It is generally accepted that long-term treatment for MGD is necessary when considering physiotherapy; however, there is considerable variation in the number and duration of IPL treatments, ranging from every few weeks or months to a single session ( 14 , 50 – 53 ). Our current results show that during the treatment process, although some cytokines reached the lowest levels after the first treatment, there were still some cytokines whose concentration continued to decline, revealing the necessity for prolonged therapy to some extent.…”

Eyelid Warming Devices: Safety, Efficacy, and Place in Therapy

“…Meibomian Gland Dysfunction: Intense Pulsed Light Therapy in Combination with Low-Level Light Therapy as Rescue Treatment. 70 11 Improved symptoms Improved tear stability Improved meibomian gland function No adverse events Epi-C Plus (IPL+LLLT) Stonecipher et al 2019. Combined low level light therapy and intense pulsed light therapy for the treatment of meibomian gland dysfunction.…”

“…In addition to varied protocols for energy delivery, IPL may also be combined with other therapies, such as meibomian gland expression 58–61 , 63 , 69 , 76 and low-level light therapy. 67 , 70 , 71 …”

“…This review found 23 studies examining the efficacy of IPL in treating MGD (Table 5). IPL improved symptoms, tear stability, and meibomian gland function in 96% (22/23), 87% (20/23), [58][59][60][61][62][63][64][65][66][68][69][70][71][72][74][75][76][77][78][79] and 87% (20/23) of studies reviewed, [58][59][60][61][63][64][65][66][67][68][69][70][71][73][74][75][76][77][78][79] respectively. Two studies reported adverse events related to using IPL.…”

“…In addition to varied protocols for energy delivery, IPL may also be combined with other therapies, such as meibomian gland expression [58][59][60][61]63,69,76 and low-level light therapy. 67,70,71 IPL is categorized under Stage 2 in the TFOS DEWS II staged management for dry eye, 2 and based on the severity of MGD and dry eye participants that have been enrolled in IPL trials IPL appears to be supported in the treatment of moderate to severe dry eye and MGD. Patients who do notrespond well to traditional eye warming therapy or have a history of ocular rosacea may be good candidates for IPL therapy.…”