Stonecipher Karl, Abell Thomas G, Chotiner Bennett, Chotiner Erik, Potvin Rick
Physicians Protocol , Greensboro, NC, USA.
Abell Eyes , Lexington, KY, USA.
Clin Ophthalmol. 2019 Jun 11;13:993-999. doi: 10.2147/OPTH.S213664. eCollection 2019.
To evaluate the effects of combined intense pulsed light therapy (IPL) and low-level light therapy (LLLT) on clinical measures of dry eye related to severe meibomian gland disease (MGD) in subjects unresponsive to previous medical management.
This was a retrospective chart review of patients treated by 4 physicians at 3 centers. All patients were documented treatment failures with traditional pharmaceutical therapy. They all had their MGD evaluated before treatment using a grading scale (0-4), tear breakup time in seconds and the Ocular Surface Disease Index (OSDI) questionnaire. To be included, all patients had to have had a short course of adjunct pharmaceutical or device-related therapy, along with a combined IPL/LLLT treatment. As well, a second MGD evaluation with the same three measures had to have been conducted 1-3 months post treatment.
A total of 460 eyes of 230 patients were identified for inclusion in the data set. Mean OSDI scores were significantly lower after treatment; 70.4% of patients had pretreatment OSDI scores indicative of dry eye; this dropped to 29.1% of patients after treatment. A 1-step or greater reduction in MGD grading was observed in 70% of eyes, with 28% of eyes having a 2-step or greater reduction. Tear breakup time was ≤6 seconds in 86.7% of eyes pretreatment, dropping to 33.9% of eyes after treatment. There were no ocular or facial adverse events or side effects related to the combined light treatment.
The use of combined IPL/LLLT for the treatment of severe MGD appears to be beneficial in patients who have failed topical and/or systemic therapy.
评估强脉冲光疗法（IPL）与低强度光疗法（LLLT）联合应用，对既往药物治疗无效的严重睑板腺功能障碍（MGD）相关干眼临床指标的影响。
这是一项对3个中心4名医生治疗的患者进行的回顾性病历审查。所有患者均记录为传统药物治疗失败。他们在治疗前均使用分级量表（0 - 4级）、泪膜破裂时间（秒）和眼表疾病指数（OSDI）问卷对MGD进行评估。纳入的所有患者均需接受过短期辅助药物或器械相关治疗，并接受IPL/LLLT联合治疗。此外，治疗后1 - 3个月必须使用相同的三项指标对MGD进行第二次评估。
共确定230例患者的460只眼纳入数据集。治疗后平均OSDI评分显著降低；70.4%的患者治疗前OSDI评分表明存在干眼，治疗后这一比例降至29.1%。70%的眼MGD分级降低了1级或更高级别，28%的眼降低了2级或更高级别。治疗前86.7%的眼泪膜破裂时间≤6秒，治疗后降至33.9%。联合光治疗未出现与眼或面部相关的不良事件或副作用。
对于局部和/或全身治疗失败的患者，使用IPL/LLLT联合治疗严重MGD似乎有益。
