Intense Pulsed Light Offers Drug and Punctal Free Meibomian Gland Treatment

An intense pulsed light treatment system shows efficacy in managing meibomian gland dysfunction 6 months after patients undergo treatment.

An intense pulsed light (IPL) system can safely and effectively deliver improved ocular surface assessments and reduce meibomian gland dysfunction (MGD) for at least 6 months, according to findings published in BMC Ophthalmology.

Researchers conducted a retrospective, nonrandomized observational study at Hospital of Saint-Etienne in France. Patients (N=45) with dry eye disease (DED) and stable symptomatic MGD for 6 months or longer who received the IPL treatment between 2019 and 2020 were evaluated for ocular surface outcomes using a diagnostic device that provides interferometry, meibography, tear meniscus height and noninvasive break up time (NIBUT) data. The treatment was performed in 3 sessions, with follow-up treatments occuring 15 and 45 days after the initial session, and consisted of 3 shots on the cheekbone and 1 on the temple.

The participants (mean age, 59±9.0 years, 30 women, 15 men) had MGD with hyposecretory status (n=6), obstructive status (n=39), eyes were cicatricial (n=5), and non-cicatricial (n=34). MGD severity was staged as 2 (n=24), stage 3 (n=19), and stage 4 (n=2).

The tear film appears to be more stable with an improvement in mucous and lipid layers observed with NIBUT and interferometry measurements and DED symptoms decrease as shown by improvement in OSDI score.

NIBUT decreased from baseline to month 3 by 1.6 seconds (P =.002), remaining significantly decreased at 6 months (P =.04). Similarly, Ocular Surface Density Index (OSDI) score (mean difference [MD], -9.2; P =.003), Oxford score (MD, -0.4; P =.0003), and interferometry (MD, -6.9; P =.042) were significantly reduced at 6 months.

No significant changes were observed at 3 months for break-up time (MD, -1.35), Schirmer test (MD, -0.1), or tear meniscus height (MD, -0.006).

No adverse events were reported during the treatment sessions. One patient reported transient redness at 1 hour after the session, which resolved within a few hours.

The limitations of this study were the lack of randomization or a comparator cohort. These findings should be confirmed in a controlled study.

This study found evidence to support the use of the IPL system for the treatment of MGD. “The tear film appears to be more stable with an improvement in mucous and lipid layers observed with NIBUT and interferometry measurements and DED symptoms decrease as shown by improvement in OSDI score,” the investigators explain. “Importantly, NIBUT, an objective parameter of tear film stability, improved in parallel with the OSDI score, a subjective parameter, in order to demonstrate DED improvement.”

Disclosure: Multiple authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please refer to the original article for a full list of disclosures.

References:

Trone M-C, Garcin T, Ollier E, Thuret G, Gain P. A retrospective study of the efficacy of intense pulsed light delivered by the Lacrystim® for meibomian gland dysfunction therapy. BMC Ophthalmol. 2022;22(1):335. doi:10.1186/s12886-022-02531-7