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 Clinic Results of Intraductal Meibomian Gland Probing Combined Intense Pulsed Light in Treating Patients With Refractory Obstructive Meibomian Gland Dysfunction: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Xiaodan Huang ◽  
Qiyu Qin ◽  
Linping Wang ◽  
Jiao Zheng ◽  
Lin Lin ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Symptom Relief ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Pulsed Light ◽  
Group I ◽  
Final Treatment ◽  
Group Ii ◽  
Better Than

Abstract Background: To optimize therapeutic regimen for refractory obstructive meibomian gland dysfunction (o-MGD) patients by combining intraductal meibomian gland probing (MGP) and intense pulsed light (IPL) to enhance their effect and reduce their limitations. Methods: This randomized, assessor blind study include 45 patients (90 eyes) with refractory o-MGD. They were divided into 3 groups by allocation concealment: IPL (group I, received an IPL treatment course: 3 times at 3-week intervals), MGP (group II, received MGP one time) and MGP combined IPL (group III, MGP at first then an IPL treatment course). Standard Patient Evaluation of Eye Dryness score (SPEED), tear break-up time (TBUT), corneal fluorescein staining (CFS), meibum grade and lid margin finding results were assessed at baseline, 3 weeks after final treatment in group I and III, 3 and 12 weeks after MGP in group II. Six months after final treatment, the SPEED and willingness to receive any treatment again were also collected in all groups. Paired Wilcoxon, Mann-Whitney U with Bonferroni correction and Kruskal-Wallis tests were used for data analysis. Results: In 3 groups, all above indexes improved significantly after treatment (all P＜0.01). MGP-IPL was better than IPL and MPG in posttreatment SPEED, TBUT, meibum grade, lid telangiectasia (all P＜0.05/3). Besides, the MGP-IPL was better than IPL in lid tenderness and better than MGP in orifices abnormality (all P＜0.05/3 ). Six months later, the SPEED in MGP-IPL was also significantly lower than other groups (all P＜0.05/3). And no patients in MGP-IPL group revealed the need to be treated again, while 35.7% or 20% of patients with IPL or MGP need retreatment. Conclusions: Compared with single IPL or MGP, the combination of MGP and IPL demonstrated the most efficient results in relieving all signs and symptoms and can help patients attain the most lasting symptom relief. Trial registration: http://clinicaltrials.gov, ChiCTR1900021273 (retrospectively registered 09 February 2019). Funding: This work was supported by the National Natural Science Foundation of China: [grant numbers: 81870624; 81700802]; Major Science and Technology Projects of Zhejiang Province [grant numbers: 2017C03046].

scholarly journals Clinical results of Intraductal Meibomian gland probing combined with intense pulsed light in treating patients with refractory obstructive Meibomian gland dysfunction: a randomized controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaodan Huang ◽  
Qiyu Qin ◽  
Linping Wang ◽  
Jiao Zheng ◽  
Lin Lin ◽  
...  
Keyword(s):  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Pulsed Light ◽  
Positive Effects ◽  
Link Type ◽  
Group I ◽  
Final Treatment ◽  
Group Ii ◽  
Better Than

Abstract Background This study aims to optimize the therapeutic regimen for refractory obstructive meibomian gland dysfunction (o-MGD) patients by combining intraductal meibomian gland probing (MGP) and intense pulsed light (IPL) to enhance their positive effects and reduce their limitations. Methods This randomized, assessor blind study includes 45 patients (90 eyes) with refractory o-MGD who were divided into 3 groups via allocation concealment: IPL (group I, received an IPL treatment course: 3 times at 3-week intervals), MGP (group II, received MGP one time), and combined MGP-IPL (group III, MGP first followed by an IPL treatment course). Standard Patient Evaluation of Eye Dryness score (SPEED), tear break-up time (TBUT), corneal fluorescein staining (CFS), meibum grade, and lid margin finding results were assessed at baseline, 3 weeks after final treatment for groups I and III, 3 and 12 weeks after MGP for group II. Six months after final treatment, the SPEED and willingness to receive any treatment again were also collected for all groups. Paired Wilcoxon, Mann-Whitney U with Bonferroni correction, and Kruskal-Wallis tests were used for data analysis. Results For all 3 groups, all previously mentioned indexes improved significantly following treatment (P<0.01). MGP-IPL was better than IPL and MGP in terms of post-treatment SPEED, TBUT, meibum grade, and lid telangiectasia (P<0.05/3). Furthermore, the MGP-IPL was better than IPL in terms of lid tenderness and better than MGP in terms of orifice abnormality (P< 0.05/3). Six months later, the SPEED for the MGP-IPL was also significantly lower than other groups (P<0.05/3). Moreover, no patients in the MGP-IPL group expressed the need to be treated again compared to 35.7% or 20% of patients in the IPL or MGP groups, respectively. Conclusions Compared with IPL or MGP alone, the combination MGP-IPL produced best results in relieving all signs and symptoms and helping patients attain long-lasting symptom relief. Trial registration http://clinicaltrials.gov, ChiCTR1900021273 (retrospectively registered February 9, 2019).

scholarly journals Use of Intense Pulsed Light to Mitigate Meibomian Gland Dysfunction for Dry Eye Disease

2020 ◽  
Vol 17 (10) ◽  
pp. 1385-1392
Author(s):  
Abhishek Suwal ◽  
Ji-long Hao ◽  
Dan-dan Zhou ◽  
Xiu-fen Liu ◽  
Raja Suwal ◽  
...  
Keyword(s):  
Dry Eye ◽  
Meibomian Gland ◽  
Dry Eye Disease ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Eye Disease ◽  
Pulsed Light

Comparison of two intense pulsed light patterns for treating patients with meibomian gland dysfunction

2020 ◽  
Vol 40 (7) ◽  
pp. 1695-1705 ◽  
Author(s):  
Yue Wu ◽  
Junhua Li ◽  
Man Hu ◽  
Yinying Zhao ◽  
Xiaolei Lin ◽  
...  
Keyword(s):  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Pulsed Light

Intense Pulsed Light for the Treatment of Dry Eye Owing to Meibomian Gland Dysfunction

10.3791/57811 ◽  
2019 ◽  
Author(s):  
Luca Vigo ◽  
Giuseppe Giannaccare ◽  
Stefano Sebastiani ◽  
Marco Pellegrini ◽  
Francesco Carones
Keyword(s):  
Dry Eye ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Pulsed Light
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