Yang Chi-Chun, Ko Yu-Chieh, Hwang De-Kuang, Chen Meng-Jou, Fan Nai-Wen
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Eye (Lond). 2025 Jul 2. doi: 10.1038/s41433-025-03886-z.
To evaluate the one-year effect of intense pulsed light (IPL) for refractory meibomian gland dysfunction (MGD) between patients treated with and without topical hypotensive agents.
This retrospective study included 21 MGD eyes of 21 glaucoma patients (age, 64.38 ± 13.74 years) and 21 MGD eyes of 21 non-glaucoma patients (age, 63.90 ± 13.50 years). Both arms received IPL therapy with meibomian gland expression (MGX). Propensity score matching ensured baseline comparability. Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, tear film breakup time (TBUT), lid telangiectasia, corneal staining, meibum quality and expressibility were assessed at baseline, 3-, 6-, 9- and 12-months post-treatment.
Both groups showed significant improvement in SPEED score and TBUT at 9 months, but only the non-glaucoma group maintained these improvements at 12 months (P < 0.01). While meibum quality improved in both groups at 12 months, significant improvement in lid telangiectasia and meibum expressibility was observed only in the non-glaucoma group. At 12 months, the non-glaucoma group showed less lid telangiectasia than the glaucoma group (P = 0.009). No other intergroup differences were found in other outcomes. Neither group showed significant improvement in corneal staining throughout the follow-up period.
IPL therapy is effective for treating refractory MGD in both glaucoma and non-glaucoma patients, with significant improvements in dry eye symptoms, tear film stability and meibum quality. However, patients on continuous hypotensive agents showed less improvement in lid telangiectasia at 12 months, suggesting that chronic hypotensive medication use may affect treatment efficacy.
评估强脉冲光(IPL)治疗难治性睑板腺功能障碍(MGD)对使用和未使用局部降压药物患者的一年疗效。
这项回顾性研究纳入了21例青光眼患者的21只MGD眼(年龄64.38±13.74岁)和21例非青光眼患者的21只MGD眼(年龄63.90±13.50岁)。两组均接受IPL治疗并联合睑板腺按摩(MGX)。倾向评分匹配确保了基线可比性。在基线、治疗后3、6、9和12个月评估干眼标准患者评估(SPEED)问卷、泪膜破裂时间(TBUT)、睑缘毛细血管扩张、角膜染色、睑脂质量和排出量。
两组在9个月时SPEED评分和TBUT均有显著改善,但只有非青光眼组在12个月时保持了这些改善(P<0.01)。虽然两组在12个月时睑脂质量均有所改善,但仅在非青光眼组观察到睑缘毛细血管扩张和睑脂排出量有显著改善。在12个月时,非青光眼组的睑缘毛细血管扩张少于青光眼组(P=0.009)。在其他结果中未发现其他组间差异。在整个随访期间,两组的角膜染色均未显示出显著改善。
IPL治疗对青光眼和非青光眼患者的难治性MGD均有效,干眼症状、泪膜稳定性和睑脂质量均有显著改善。然而,持续使用降压药物的患者在12个月时睑缘毛细血管扩张的改善较少,提示长期使用降压药物可能会影响治疗效果。