Lee Hayoung, Jeon Yoo Young, Eah Kyu Sang, Park Nahyun, Lee Yea Eun, Han Jeewon, Lee Chung Min, Kim Changmin, Chung Ho Seok, Kim Jae Yong, Lee Hun
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
Department of Ophthalmology, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
J Clin Med. 2025 Jan 1;14(1):199. doi: 10.3390/jcm14010199.
To compare the long-term efficacy and safety of intense pulsed light (IPL) treatments using a 590-nm and an acne filter. In this prospective, randomized, paired-eye trial study, 30 patients with moderate and severe meibomian gland dysfunction (MGD) were followed up for at least one month after their last treatment. Group A received IPL treatment with an acne filter, a type of notch filter that blocks wavelengths between 600 and 800 nm, allowing IPL to emit wavelengths between 400-600 nm and 800-1200 nm. Group B received treatment with a 590 nm filter, a type of cut-off filter that blocks wavelengths below 590 nm. Clinical parameters, including tear osmolarity, matrix metalloproteinase (MMP)-9 expression, tear break-up time, ocular surface staining scores, Schirmer's test I, lid margin telangiectasia scores, MG expressibility/secretion scores, and Ocular Surface Disease Index scores, were measured at baseline, 1, 6, and 12 months after their last treatment. In the linear mixed model, significant time effects on all clinical parameters, except for MMP-9 grades and Schirmer's test I results, were observed within each group. However, interactions between time points (baseline, 6 months, 12 months) and groups (Group A, B) were not significant. The generalized estimating equation model showed no significant interaction between time points and groups for MMP-9 positivity; however, a significant time effect on MMP-9 positivity was observed in Group A, with a decrease at 12 months after their last treatment when compared to baseline and 6 months. The IPL treatment modality for moderate to severe MGD demonstrated a significant therapeutic effect for one year under strictly controlled self-administration of other treatments. IPL treatment using acne filter is a promising treatment option for reducing MMP-9 positivity in MGD patients.
比较使用590纳米和痤疮滤光片的强脉冲光（IPL）治疗的长期疗效和安全性。在这项前瞻性、随机、双眼配对试验研究中，30例中重度睑板腺功能障碍（MGD）患者在最后一次治疗后至少随访1个月。A组接受使用痤疮滤光片的IPL治疗，痤疮滤光片是一种陷波滤光片，可阻挡600至800纳米之间的波长，使IPL能够发射400 - 600纳米和800 - 1200纳米之间的波长。B组接受使用590纳米滤光片的治疗，590纳米滤光片是一种截止滤光片，可阻挡低于590纳米的波长。在基线、最后一次治疗后1、6和12个月测量临床参数，包括泪液渗透压、基质金属蛋白酶（MMP）-9表达、泪膜破裂时间、眼表染色评分、Schirmer试验I、睑缘毛细血管扩张评分、MG排出/分泌评分和眼表疾病指数评分。在线性混合模型中，每组内除MMP - 9分级和Schirmer试验I结果外，所有临床参数均观察到显著的时间效应。然而，时间点（基线、6个月、12个月）和组（A组、B组）之间的交互作用不显著。广义估计方程模型显示，时间点和组之间对于MMP - 9阳性无显著交互作用；然而，在A组中观察到对MMP - 9阳性有显著的时间效应，与基线和6个月相比，最后一次治疗后12个月时有所下降。在严格控制其他治疗的自我给药情况下，中重度MGD的IPL治疗方式在一年内显示出显著的治疗效果。使用痤疮滤光片的IPL治疗是降低MGD患者MMP - 9阳性的一种有前景的治疗选择。
