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睑板腺功能障碍所致干眼疾病不同模式强脉冲光治疗的网状Meta分析

Network meta-analysis of different modalities of intense pulsed light therapy in the treatment of dry eye disease induced by meibomian gland dysfunction.

作者信息

Cong Jing, Wu Yiting, Dong Chunqiong, Cheng Yiwen, Lin Xueqi, Yuan Jiayue, Feng Qianhong, Liu Shichu, Dai Jinhui, Ma Xiaoping, Xie Xinyi

机构信息

Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, China.

Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

Lasers Med Sci. 2025 Jun 26;40(1):303. doi: 10.1007/s10103-025-04545-1.

DOI:10.1007/s10103-025-04545-1
PMID:40569448
Abstract

PURPOSE

This network meta-analysis aimed to evaluate the comparative effect of five different protocols of IPL treatment in treating MGD-related DED, including optimal pulse technology [OPT]-based IPL, E > eye-based IPL, OPT-based IPL plus meibomian gland expression (MGX), E > eye-based IPL plus MGX, Eyesis-based IPL plus MGX.

METHODS

PubMed, Embase, Cochrane Library, SCOPUS and China National Knowledge Infrastructure (CNKI) were searched for eligible studies published before November 10, 2022.

RESULTS

Random network meta-analysis was conducted to estimate the differences between different protocols of IPL treatment in ocular surface disease index (OSDI), standard patient evaluation of eye dryness (SPEED), tear break-up time (TBUT), meibomian gland quality (MGQ), meibomian gland evaluation (MGE), and corneal fluorescein staining (CFS). Rank probability showed OPT-based IPL plus MGX ranked first in OSDI and SPEED, E > eye-based IPL plus MGX ranked first in TUBT, MGQ, and CFS, but Eyesis-based IPL plus MGX ranked first in MGE.

CONCLUSIONS

Based on available evidence, for individuals with MGD-related DED, OPT-based IPL plus MGX may be the preferred treatment protocol for relieving ocular symptoms, but E > eye-based IPL plus MGX may be more beneficial for improving ocular function.

摘要

目的

本网络荟萃分析旨在评估五种不同的强脉冲光(IPL)治疗方案在治疗睑板腺功能障碍相关干眼(MGD-related DED)中的比较效果,包括基于优化脉冲技术(OPT)的IPL、基于E>eye的IPL、基于OPT的IPL联合睑板腺按摩(MGX)、基于E>eye的IPL联合MGX、基于Eysis的IPL联合MGX。

方法

检索了PubMed、Embase、Cochrane图书馆、SCOPUS和中国知网(CNKI),以查找2022年11月10日前发表的符合条件的研究。

结果

进行随机网络荟萃分析,以估计不同IPL治疗方案在眼表疾病指数(OSDI)、干眼标准患者评估(SPEED)、泪膜破裂时间(TBUT)、睑板腺质量(MGQ)、睑板腺评估(MGE)和角膜荧光素染色(CFS)方面的差异。排序概率显示,基于OPT的IPL联合MGX在OSDI和SPEED方面排名第一,基于E>eye的IPL联合MGX在TBUT、MGQ和CFS方面排名第一,但基于Eysis的IPL联合MGX在MGE方面排名第一。

结论

根据现有证据,对于MGD相关干眼患者,基于OPT的IPL联合MGX可能是缓解眼部症状的首选治疗方案,但基于E>eye的IPL联合MGX可能对改善眼部功能更有益。

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本文引用的文献

1
Effect of Intense Pulsed Light Therapy in Dry Eye Disease Caused by Meibomian Gland Dysfunction: A Systematic Review and Meta-Analysis.强脉冲光疗法治疗睑板腺功能障碍引起的干眼的疗效:系统评价和荟萃分析。
Eye Contact Lens. 2022 Oct 1;48(10):424-429. doi: 10.1097/ICL.0000000000000934. Epub 2022 Sep 5.
2
Prevalence and risk factors of dry eye disease among University Students in Bangkok, Thailand.泰国曼谷大学生干眼症的患病率及危险因素。
PLoS One. 2021 Oct 1;16(10):e0258217. doi: 10.1371/journal.pone.0258217. eCollection 2021.
3
Tear film interferometry assessment after intense pulsed light in dry eye disease: A randomized, single masked, sham-controlled study.
干眼症患者强脉冲光治疗后泪膜干涉测量评估:一项随机、单盲、假对照研究。
Cont Lens Anterior Eye. 2022 Aug;45(4):101499. doi: 10.1016/j.clae.2021.101499. Epub 2021 Aug 22.
4
Treatment of contact lens related dry eye with intense pulsed light.强脉冲光治疗接触镜相关干燥性眼。
Cont Lens Anterior Eye. 2022 Apr;45(2):101449. doi: 10.1016/j.clae.2021.101449. Epub 2021 Apr 28.
5
Comparison of intense pulsed light and near-infrared light in the treatment of dry eye disease: a prospective randomized study.强脉冲光与近红外光治疗干眼症的比较:前瞻性随机研究。
Acta Ophthalmol. 2021 Dec;99(8):e1307-e1314. doi: 10.1111/aos.14833. Epub 2021 Apr 25.
6
Intense pulsed light plus meibomian gland expression versus intense pulsed light alone for meibomian gland dysfunction: A randomized crossover study.强脉冲光联合睑板腺按摩与单纯强脉冲光治疗睑板腺功能障碍的随机交叉研究。
PLoS One. 2021 Mar 4;16(3):e0246245. doi: 10.1371/journal.pone.0246245. eCollection 2021.
7
Comparative Evaluation in Intense Pulsed Light Therapy Combined with or without Meibomian Gland Expression for the Treatment of Meibomian Gland Dysfunction.强脉冲光治疗联合或不联合睑板腺按摩治疗睑板腺功能障碍的疗效比较。
Curr Eye Res. 2021 Aug;46(8):1125-1131. doi: 10.1080/02713683.2020.1867750. Epub 2021 Jan 18.
8
Prevalence of symptomatic dry eye in breast cancer patients undergoing systemic adjuvant treatment: A cross-sectional study.接受全身辅助治疗的乳腺癌患者中症状性干眼的患病率:一项横断面研究。
Breast. 2020 Oct;53:164-171. doi: 10.1016/j.breast.2020.07.009. Epub 2020 Aug 5.
9
Intense pulsed light for meibomian gland dysfunction: a systematic review and meta-analysis.强脉冲光治疗睑板腺功能障碍:系统评价和荟萃分析。
Graefes Arch Clin Exp Ophthalmol. 2021 Jan;259(1):1-10. doi: 10.1007/s00417-020-04834-1. Epub 2020 Jul 28.
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The Efficacy of Intense Pulsed Light Combined With Meibomian Gland Expression for the Treatment of Dry Eye Disease Due to Meibomian Gland Dysfunction: A Multicenter, Randomized Controlled Trial.强脉冲光联合睑板腺按摩治疗睑板腺功能障碍相关性干眼的疗效:一项多中心、随机对照研究。
Eye Contact Lens. 2021 Jan 1;47(1):45-53. doi: 10.1097/ICL.0000000000000711.