scholarly journals Evaluation of the Safety and Effectiveness of Intense Pulsed Light in the Treatment of Meibomian Gland Dysfunction

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaodan Jiang ◽  
Huibin Lv ◽  
Hang Song ◽  
Mingzhou Zhang ◽  
Yan Liu ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Conjunctival Injection ◽  
Pulsed Light ◽  
Open Label ◽  
Eyelid Margin ◽  
Efficient Treatment ◽  
Meibomian Gland Secretion ◽  
Tear Meniscus Height

Purpose.This study aims to explore the safety and efficacy of a novel treatment-intense pulsed light (IPL) in MGD eyes.Methods.This study is a prospective and open label study. Forty eyes of 40 MGD patients were recruited in the study and received 4 consecutive IPL treatments on day 1, day 15, day 45, and day 75. Ten ocular surface symptoms were evaluated with a subjective face score at every visit. Best spectacle corrected visual acuity, intraocular pressure (IOP), conjunctival injection, upper and lower tear meniscus height (TMH), tear break-up time (TBUT), corneal staining, lid margin and meibomian gland assessments, and meibography were also recorded at every visit, as well as the adverse effects on the eye and ocular surface.Results.Significant improvements were observed in single and total ocular surface symptom scores, TBUT, and conjunctival injection at all the visits after the initial IPL treatment (P<0.05). Compared to baseline, the signs of eyelid margin, meibomian gland secretion quality, and expressibility were significantly improved at every visit after treatments. There was no regional and systemic threat observed in any patient.Conclusion.Intense pulsed light (IPL) therapy is a safe and efficient treatment in relieving symptoms and signs of MGD eyes.

scholarly journals Intense Pulsed Light Therapy with Optimal Pulse Technology as an Adjunct Therapy for Moderate to Severe Blepharitis-Associated Keratoconjunctivitis

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Fang Ruan ◽  
Yunxiao Zang ◽  
Ruti Sella ◽  
Hongshuang Lu ◽  
Shang Li ◽  
...  
Keyword(s):  
Treatment Group ◽  
Outcome Measures ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Pulsed Light ◽  
Ocular Surface Disease Index ◽  
Open Label ◽  
Eyelid Margin ◽  
Adjunct Therapy ◽  
Pulse Technology

Purpose. To evaluate the intense pulsed light (IPL) therapy with optimal pulse technology (OPT, M22™, Lumenis, USA) as an adjunct therapy for the prevention of recurrences in moderate to severe blepharokeratoconjunctivitis (BKC). Methods. This open-label nonrandomized clinical trial evaluated 33 patients diagnosed with BKC. Twenty-one patients received four bilateral OPT therapy sessions with Meibomian gland expression (MGX) (treatment group), and 11 patients received MGX alone (controls). This trial was initiated after a four-week pharmacotherapy for BKC in both groups and was scheduled at four-week intervals. Efficacy outcome measures included meibum quality, Meibomian gland (MG) secretion function, eyelid margin signs, corneal fluorescein staining (CFS) score, noninvasive keratography breakup time (NIKBUT), ocular surface disease index (OSDI) score, Schirmer I test (SIT), classification of tear film lipid layer (TFLL), and Meibomian gland dropout (MGDR). Safety outcome measures included visual acuity, intraocular pressure, eye structure damage, and facial skin appearance at each visit. Results. Quality of meibum, MG expressibility, eyelid margin signs, and OSDI score showed a statistically significant greater improvement in the treatment group after one to three treatment sessions, compared to controls (p<0.05). While these improved in both groups in comparison to baseline, the NIKBUT and upper and lower eyelid MGDRs significantly improved only in the treatment group (p<0.05). No adverse events occurred in both groups. No BKC recurrences were noted in the treatment group. Conclusions. IPL is a safe and effective adjuvant treatment for BKC and possibly more effective in reducing eyelid margin inflammation and prevents recurrences than MGX alone. This trial is registered with ChiCTR-ONN-17013864.

scholarly journals Alternation of Lipidomic in the Meibomian Gland After Exposure to Intense Pulsed Light in Patients With Meibomian Gland Dysfunction and Suggestions for Applications of 3PM Medicine

2021 ◽  
Author(s):  
Hui Zhao ◽  
Shang-Kun Ou ◽  
Li-Ying Tang ◽  
Yi Shao ◽  
Shi-Nan Wu ◽  
...  
Keyword(s):  
Expression Profiles ◽  
Meibomian Gland ◽  
Lipid Profiles ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Pulsed Light ◽  
Fluorescein Staining ◽  
Meniscus Height ◽  
Tear Meniscus ◽  
Tear Meniscus Height

Abstract Importance: Aside from the clinical index, there is no established criterion for assessing the effectiveness of intense pulsed light (IPL) in treating meibomian gland disease.Objective：To determine if there is an association between changes in the meibum lipidomic profiles and alleviation of clinical signs in patients with meibomian gland dysfunction (MGD) who are treated with IPL. To provide predictive, preventive and and personalized medical programs for MGD patients. Design: This is an observational Study. Patients were followed for up for 6 months from January 1, 2019.Setting: This is a single center, human-oriented clinical and basic research study.Participants: Adult patients, who were diagnosed with MGD and had not received any alternative treatments for at least 3 months, were enrolled in the study. Exposures: Each patient received a series of three treatments at 3-week intervals. The meibum was collected before the first treatment (T0) and the third treatment (T2). All enrolled patients completed the whole examination and treatment. The meibum of randomly assigned 26 patients and 10 healthy volunteers was chosen for performing the lipid analysis using LC-MS/MS. Main Measures: The following information from each patient was recorded: tear break-up time (BUT), average tear BUT, tear meniscus height, assessment of the lid margin, bulbar redness, meibomian gland opening position, corneal fluorescein staining, meibomian gland drop, meibomian gland expressibility, and meibum quality.Results: A total of 191 patients’ right eyes were enrolled in the study, including 95 females (49.7%) and 96 males (50.3%), with a median age of 53 years (range: 28–85 years). IPL increased the BUT (P<0.0001, t=7.9, df=380), average tear BUT (P<0.01, t=2.774, df=374.5), and tear meniscus height (P<0.01, t=2.642, df=367.1). At the same time, IPL improved bulbar redness (P<0.0001, t=12.95, df=380) and corneal fluorescein staining (P<0.0001, t=4.147, df=380). Furthermore, following IPL treatment, the meibomian gland expressibility (MGE) and meibum quality were significantly improved (from 1.342±0.05815 to 0.9354±0.03922, P<0.0001, t=5.798, df=380 and from 1.266±0.04969 to 0.8639±0.03318, P<0.0001, t=6.733, df=380, respectively). Lipidomic analysis of the meibum characterized the changes in lipid profiles induced by IPL. Conclusion: IPL treatment offers a novel approach to markedly improve the treatment of patients with MGD due to correction of altered lipid profiles. The changes in lipid expression profiles are potential indexes to evaluate the therapeutic effectiveness of IPL treatment or other treatments on MGD. The lipid changes that are pertinent include: LPC(18:2)+HCOO, OAHFA(18:1/34:1)-H, TG(16:0/18:2/20:5)+H, and etc.. Therefore, accurate evaluation of the changes of lipid expression profile in patients with MGD can be used as a predictive, preventive, and personalized medical method.

scholarly journals Effects of intense pulsed light treatment on tear cytokines and clinical outcomes in meibomian gland dysfunction

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256533
Author(s):  
Qian Li ◽  
Junxiu Liu ◽  
Cheng Liu ◽  
Junfeng Piao ◽  
Wei Yang ◽  
...  
Keyword(s):  
Inflammatory Cytokines ◽  
Ocular Surface ◽  
Signs And Symptoms ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Tissue Inhibitor Of Metalloproteinase ◽  
Meibomian Gland Dysfunction ◽  
Pulsed Light ◽  
Tnf Α ◽  
Ifn Γ

Meibomian gland dysfunction (MGD) has become a prevalent ocular surface disorder. Its pathogenesis is regarded as a self-perpetuating inflammatory vicious circle. Intense Pulsed Light (IPL) treatment was recently applied to improve the meibomian gland function and reduce symptoms of MGD. However, studies investigating the change of specific inflammatory cytokines during IPL treatment remained sparse. To further figure out how IPL treatment modulates the inflammatory cytokines in tears of MGD, we therefore performed a cross-sectional study and enrolled 32 patients from March 2019 to December 2020. The patients received 3 sessions of IPL treatment (10 to 16 J/cm2) at 4-week interval. The signs and symptoms of MGD were evaluated by ocular surface disease index (OSDI), tear film breakup time (TBUT), and meibomian gland yield secretion score (MGYSS). The clinical evaluators and tear samples were analyzed at baseline and at each IPL treatment session. Concentrations of (chemokine ligand) CXCL1, (C-C motif chemokine) CCL11, (tumor necrosis factor) TNF-α, (interferon) IFN-γ, (interleukin) IL-2, IL-6 and (tissue inhibitor of metalloproteinase) TIMP-1were measured by Quantibody Human Dry Eye Disease Array1. OSDI significantly decreased after IPL treatment compared with baseline. TBUT and MGYSS increased consecutively during treatment. CXCL1, CCL11, TNF-α, IFN-γ, IL-2, IL-6 presented significantly decrease and TIMP-1 showed significantly increase from the pretreatment baseline. The changed concentrations of TNF-α, IFN-γ, IL-2, TIMP-1 correlated with TBUT, the changed values of CXCL1, TNF-α, IFN-γ, CCL11, IL-2, IL-6, TIMP-1 correlated with MGYSS, and the changed concentrations of CXCL1, IFN-γ, CCL11, IL-2, IL-6 correlated with TIMP-1. The data supported IPL treatment could significantly relieve both signs and symptoms of MGD. The therapeutic effect of IPL treatment may originate from regulation of inflammatory cytokines including CXCL1, TNF-α, IFN-γ, CCL11, IL-2, IL-6, and TIMP-1.

scholarly journals Factors Influencing the Effectiveness of Intense Pulsed Light for Meibomian Gland Dysfunction

2020 ◽  
Author(s):  
Chen Chen ◽  
Di Chen ◽  
Yu-yu Chou ◽  
qin long
Keyword(s):  
Influencing Factors ◽  
Clinical Symptoms ◽  
Influencing Factor ◽  
Univariate Analysis ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Pulsed Light ◽  
Ocular Surface Disease Index ◽  
Eyelid Margin

Abstract Purpose: To observe the effectiveness of intense pulsed light (IPL) for meibomian gland dysfunction (MGD) and identify its influencing factors. Methods: Forty-eight eyes of 48 patients with MGD were included. Subjects were followed up 5 times and received IPL during the first three visits. Gender, age, duration of MGD, time of video display terminal usage, and severity of MGD were recorded at baseline. At every visit, Ocular Surface Disease Index (OSDI), eyelid margin abnormality score (EMAS), tear film breakup time (TBUT), Schirmer Ⅰ test (SⅠt) and corneal fluorescein staining (CFS) were recorded. The clinical parameters before and after 3 IPL treatments were compared. Univariate and multivariable logistic regression analyses were performed to explore influencing factors. Results: Compared with baseline, the TBUT was increased and the CFS score and OSDI were significantly decreased on day 45 and day 120 (all P < 0.001). In univariate analysis, among the patients with a younger age (18-39 years), moderate MGD, higher baseline SIt and higher baseline OSDI, the IPL treatment had a higher effective rate (P = 0.032, 0.004, 0.024 and 0.014 respectively). The MGD severity was strongly associated with effective IPL, and patients with moderate MGD had an OR of 5.493 compared with the severe MGD patients (OR = 22.454, 95% CI: 2.890-174.436, P = 0.003). Conclusions: IPL effectively improves clinical symptoms and some signs in MGD patients. Age, MGD severity, baseline SIt and baseline OSDI are potential factors that may influence the effectiveness of IPL. MGD severity is an independent influencing factor.

scholarly journals Therapeutic Effect of Intense Pulsed Light (IPL) Combined with Meibomian Gland Expression (MGX) on Meibomian Gland Dysfunction (MGD)

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Shanshan Wei ◽  
Xiaotong Ren ◽  
Yuexin Wang ◽  
Yilin Chou ◽  
Xuemin Li
Keyword(s):  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Pulsed Light ◽  
Ocular Surface Disease Index ◽  
Eyelid Margin ◽  
Assessment Scores ◽  
Before And After ◽  
Corneal Nerve

Purpose. Our study aimed to evaluate the efficiency of intense pulsed light (IPL) combined with meibomian gland expression (MGX) in treating meibomian gland dysfunction (MGD). Methods. This study was a prospective interventional study. A total of 53 patients were included in the study and received a series of three treatments at an interval of 3-4 weeks. Follow-up examinations were completed 4 weeks after the last treatment. The Ocular Surface Disease Index (OSDI) questionnaire, tear meniscus height (TMH), tear break-up time (TBUT), slit-lamp examinations, and in vivo confocal microscopy (IVCM) were recorded before and after treatment. Additionally, an artificial intelligence automated software program was applied in our study for corneal nerve analysis. Results. The OSDI score was significantly reduced after the IPL treatment compared with baseline (P<0.001). Meibomian gland assessment scores, including meibum quality and expressibility, eyelid margin abnormalities, and corneal staining, significantly decreased after treatment (P<0.05). Moreover, the corneal nerve fiber length (CNFL) significantly increased after the treatment (P<0.001). Conclusion. Intense pulsed light (IPL) combined with MGX is an effective treatment for MGD, and neurotrophism could be one of the mechanisms of IPL.

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