Randomised double-masked placebo-controlled trial of the cumulative treatment efficacy profile of intense pulsed light therapy for meibomian gland dysfunction

The use of intense pulsed light therapy in the treatment of refractory meibomian gland dysfunction

“…Furthermore, reductions in the expression of IL-6, IL-17A, and PGE2 was observed to be associated with improvements in clinical ocular surface parameters in a recent double-masked, paired eye, randomized, sham-controlled trial [15]. Another double-masked, parallelgroup, randomized, sham-controlled trial reported inhibition of periocular Corneybacterium macginleyi load following four sessions of IPL therapy [14].…”

“…The clinical safety and tolerability of IPL therapy have been confirmed by numerous clinical studies which report no major adverse events following IPL therapy [14,16,[19][20][21][22][23][24][25][26][27][28]. However, minor or transient side effects, including mild pain, light sensitivity, eyelash loss, eyelid erythema, crusting, hyperpigmentation, and blistering have been described [12,[29][30][31].…”

“…It has been hypothesized that ocular Demodex might be targeted by the thermal energy delivered by IPL devices [9][10][11]13]. In addition, a recent randomized trial showed that a three-month course of IPL therapy inhibited periocular Corneybacterium macginleyi load [14]. Furthermore, the anti-inflammatory action of IPL therapy has also been demonstrated with the reduction of inflammatory markers in tear samples, including IL-4, IL-6, IL-10, IL-17A, TNF-α, and PGE2 [15,16].…”

“…To date, a total of five randomized trials investigating the efficacy of IPL therapy for the treatment of MGD have been published [14,15,28,31,38], as summarized in Table 1, and ongoing randomized trials are highlighted in Table 2. Improvements in dry eye symptomology scores, tear film stability, lipid layer thickness, meibomian gland expressibility and capping, and corneal fluorescein staining have been reported following three to four sessions of IPL therapy in these randomized studies [14,15,28,31,38]. Furthermore, reductions in the expression of IL-6, IL-17A, and PGE2 was observed to be associated with improvements in clinical ocular surface parameters in a recent double-masked, paired eye, randomized, sham-controlled trial [15].…”

“…To date, only a limited number of studies have investigated treatment outcomes beyond the completion of the IPL treatment course. As summarized in Table 1, two randomized trials reported sustained improvements in ocular surface parameters at one and six months following the completion of the IPL treatment course, respectively [14,28]. Another prospective non-randomized study reported sustained improvements in dry eye symptomology and meibomian gland expressibility up to 12 months posttreatment, but not tear film stability or corneal staining [26].…”