Lee Yunhan, Jang Joon Hyuck, Nam Sanghyu, Lee Koeun, Kim Jin, Kim Jae Yong, Tchah Hungwon, Lee Hun
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
J Clin Med. 2022 Aug 12;11(16):4724. doi: 10.3390/jcm11164724.
We aimed to investigate the prognostic factors for, and treatment efficacy of, intense pulsed light (IPL) treatment with a vascular filter in patients with moderate or severe meibomian gland dysfunction (MGD). In this retrospective observational study, 58 moderate or severe MGD patients who underwent IPL treatment with a vascular filter were enrolled. IPL treatment was administered to the upper and lower eyelids four times at two-week intervals. At baseline, and four weeks after IPL, we evaluated the matrix metalloproteinase (MMP)-9 expression levels, tear break-up times (TBUT), ocular surface staining scores, lid margin telangiectasias, and meibomian gland characteristics. The subjective symptoms and adverse effects were reviewed and recorded. Regression analyses were performed to explore the prognostic factors affecting clinical outcomes. IPL treatment using a vascular filter led to improvements in the TBUT, ocular surface staining score, meibomian gland grade, meibum quality and consistency, lid margin telangiectasia, and symptom score (all p < 0.001). Furthermore, the positivity rate (90.2% to 70.6%, p = 0.013) and expression levels (1.92 ± 1.18 to 1.24 ± 1.18, p < 0.001) of tear MMP-9 improved after the IPL treatment. In multivariate logistic regression analysis, a young age (odds ratio = 0.867, p = 0.007) and a toothpaste-like consistency in the upper lid (odds ratio = 8.449, p = 0.046) were associated with improvements in the meibomian gland grade. No adverse effects were detected. IPL with a vascular filter is a safe and effective treatment for moderate and severe MGD. Age and the meibum consistency in the upper lid are important prognostic factors.
我们旨在研究使用血管滤光片的强脉冲光（IPL）治疗中度或重度睑板腺功能障碍（MGD）患者的预后因素及治疗效果。在这项回顾性观察研究中，纳入了58例接受使用血管滤光片的IPL治疗的中度或重度MGD患者。IPL治疗以两周为间隔对上下眼睑各进行4次。在基线时以及IPL治疗后4周，我们评估了基质金属蛋白酶（MMP）-9表达水平、泪膜破裂时间（TBUT）、眼表染色评分、睑缘毛细血管扩张以及睑板腺特征。对主观症状和不良反应进行了回顾和记录。进行回归分析以探索影响临床结果的预后因素。使用血管滤光片的IPL治疗使TBUT、眼表染色评分、睑板腺等级、睑脂质量和稠度、睑缘毛细血管扩张以及症状评分均得到改善（所有p<0.001）。此外，IPL治疗后泪液MMP-9的阳性率（从90.2%降至70.6%，p = 0.013）和表达水平（从1.92±1.18降至1.24±1.18，p<0.001）有所改善。在多因素逻辑回归分析中，年轻（比值比=0.867，p = 0.007）以及上睑睑脂呈牙膏样稠度（比值比=8.449，p = 0.046）与睑板腺等级的改善相关。未检测到不良反应。使用血管滤光片的IPL是治疗中度和重度MGD的一种安全有效的方法。年龄和上睑睑脂稠度是重要的预后因素。
