International ophthalmologyMay 10, 2022

Combined light therapy, heat treatment, and gland massage for stubborn meibomian gland problems

Longevity & Aging Weekly Brief ↗PubMed ↗DOI ↗

Updated May 1, 2026

Abstract

Significant improvements were observed in Ocular Surface Disease Index (OSDI), non-invasive tear film break-up time (NIBUT), lipid layer thickness (LLT), and meibomian gland expressibility (MGE) after treatment.

Patients underwent a combination treatment of intense pulsed light (IPL), LipiFlow, and manual meibomian gland expression (MGX) for refractory meibomian gland dysfunction (MGD).
Improvements in OSDI, NIBUT, LLT, and MGE were maintained over a 12-month follow-up period.
Tear meniscus height (TMH) and meibomian gland morphology (meiboscore) did not change during follow-up.
No serious adverse events were reported during the treatment and follow-up period.
Combination therapy may be effective for patients who do not respond adequately to conventional MGD treatments.

Simplified

PURPOSE: To evaluate the clinical efficacy and safety of combination treatment with intense pulsed light (IPL), LipiFlow thermal pulsation, and manual meibomian gland expression (MGX) for patients with refractory meibomian gland dysfunction (MGD).

METHODS: A total of 23 eyes from 23 patients who underwent combination treatment with IPL, LipiFlow, and MGX for refractory MGD were included in the study. All patients were followed up for 12 months after the first treatment. All patients were examined prior to treatment and underwent three sessions of IPL, LipiFlow, and MGX, a subsequent three sessions of IPL and MGX, and six subsequent sessions of MGX. Patients were examined 10 weeks, 6 months, and 12 months after the first treatment. The ophthalmologic examination included ocular surface disease index (OSDI), non-invasive tearfilm break-up time (NIBUT), lipid layer thickness (LLT), meibomian gland expressibility (MGE), meibomian gland morphology (meiboscore), and tear meniscus height (TMH).

RESULTS: OSDI, NIBUT, LLT, and MGE significantly improved with treatment, which was maintained during the follow-up period. TMH and meiboscore remained unchanged throughout follow-up. No serious adverse events occurred during follow-up.

CONCLUSIONS: Combination therapy with IPL, LipiFlow, and MGX was clinically effective and safe for the treatment of refractory MGD. Combination treatment could be considered for patients with insufficient improvement despite conventional MGD treatments, including IPL treatment with MGX.

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Combined light therapy, heat treatment, and gland massage for stubborn meibomian gland problems

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