Efficacy of Intense Pulsed Light and Meibomian Gland Expression Treatments in Meibomian Gland Dysfunction: A Meta-Analysis of Randomized Controlled Trials

Purpose: This review aimed to evaluate the efficacy and safety of intense pulsed light treatment (IPLT) combined with meibomian gland expression treatments(MGXT) in meibomian gland dysfunction.Methods: We conducted a meta-analysis of randomized controlled trials that compared the efficacy of IPLT and MGXT in the treatment of dry eye disease (DED). The meibomian gland yielding secretion score was the primary outcome, whereas the secondary outcomes included the Meiboscore, tear breakup time in seconds, Standard Patient Evaluation for Eye Dryness and Corneal Fluorescein Staining .Results: This study consisted of 6 trials with 326 patients. Significantly greater improvement was observed in meibomian gland yielding secretion score at 1 month [MD: 13.69 (95% CI, 11.98, 15.40)] and at 3 months [MD: 11.03 (95% CI, 10.27, 11.80)], low meibomian gland yielding secretion score at 1 month [MD: 6.92 (95% CI, 5.49, 8.34)] and at 3 months MD: 6.80 (95% CI, 5.01, 8..59)], up meibomian gland yielding secretion score at 1 month [MD: 6.41 (95% CI, 4.12, 8.70)] and at 3 months [MD: 8.06 (95% CI, 5.70, 10.42)] and tear breakup time at 1 month [MD: 2.38 (95% CI, 1.83, 2.92)] and at 3 months [MD: 1.82 (95% CI, 1.48, 2.19)] in the IPL-MGX group than in the MGX group.Conclusions: IPL-MGX is safer and more efficacious as compared to the MGX alone in the treatment of patients with MGD-related dry eye. We recommend discussing the decision with the ophthalmologist for an appropriate choice.