Department of Ophthalmology, Hospital Clinico San Carlos, Madrid, Spain.
Universidad Complutense de Madrid, Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Madrid, Spain.
Eur J Ophthalmol. 2024 May;34(3):700-707. doi: 10.1177/11206721231199121. Epub 2023 Sep 6.
To demonstrate that intense pulsed light therapy (IPL) of the upper and lower eyelids with meibomian gland expression (MGX) is effective in improving dry eye disease due to meibomian gland dysfunction (MGD).
Patients with ocular discomfort (Ocular Surface Disease Index -OSDI- above 13) and signs of MGD were recruited. All patients underwent OSDI, visual acuity (VA), intraocular pressure, Schirmer test, meibography, non-invasive tear breakup time (NITBUT), slit-lamp examination (corneal and conjunctival staining, hyperemia, gland expressibility, and meibum quality), tear osmolarity and lipid layer thickness. IPL was performed with Optima IPL (Lumenis Ltd.) following a standardized protocol on upper and lower eyelids of both eyes, with inferior eyelid MGX. Patients received four sessions separated by two weeks each. Four weeks after, examinations were repeated.
160 patients (320 eyes) were included, of which 108 (67.5%) were women and mean age was 59.2 ± 15.08 (range 20-89). After four sessions, VA, OSDI, tear osmolarity, lipid layer thickness, NITBUT, hyperemia, corneal and conjunctival staining, gland expressibility, meibum quality, inferior eyelid Meiboscore and Schirmer test improved (all, p < 0.027). Changes in OSDI, initial and average NITBUT increased with dry eye disease severity (according to OSDI). Increased pre-treatment OSDI, hyperemia, corneal and conjunctival staining and Schirmer test were associated with an improvement in OSDI (all, p < 0.040). No adverse events were noted.
The combination of IPL on upper and lower eyelids with MGX is safe and effective for the treatment of MGD. Patients with severe dry eye disease present greater improvements.
证明强脉冲光疗法（IPL）治疗上下眼睑的睑板腺功能障碍（MGD）相关的眼干，是有效的。
招募眼部不适（眼表疾病指数 - OSDI 超过 13）和 MGD 体征的患者。所有患者均行 OSDI、视力（VA）、眼压、泪膜破裂时间（NITBUT）、泪膜摄影、非侵入性泪膜破裂时间（NITBUT）、裂隙灯检查（角膜和结膜染色、充血、腺体分泌和睑脂质量）、泪液渗透压和脂质层厚度检查。采用 Optima IPL（Lumenis Ltd.）进行 IPL，双眼上下眼睑行标准化治疗方案，下眼睑行睑板腺挤压。患者每两周行一次治疗，共四次。四周后，重复检查。
纳入 160 例（320 只眼）患者，其中女性 108 例（67.5%），平均年龄 59.2±15.08 岁（20-89 岁）。四次治疗后，VA、OSDI、泪液渗透压、脂质层厚度、NITBUT、充血、角膜和结膜染色、腺体分泌、睑脂质量、下眼睑 Meiboscore 和 Schirmer 试验均改善（均 p<0.027）。OSDI、初始和平均 NITBUT 改善与干眼严重程度相关（根据 OSDI）。治疗前 OSDI 升高、充血、角膜和结膜染色、Schirmer 试验与 OSDI 改善相关（均 p<0.040）。无不良反应发生。
上下眼睑 IPL 联合睑板腺挤压术治疗 MGD 安全有效，且严重干眼患者获益更多。
