Significant improvements were observed in several clinical measures after three /MGX treatments in 44 patients with .
Standard Patient Evaluation of Eye Dryness, Ocular Surface Disease Index, tear break-up time, corneal fluorescein staining score, meibomian gland yielding secretion score, meibomian glands yielding clear secretion, and meibomian glands yielding liquid secretion showed significant improvement post-treatment.
Meiboscore and meibomian gland loss score did not change after treatment.
Younger patients with better treatment outcomes had a mean age of 36.0 years compared to 53.0 years for less responsive patients.
Patients with longer tear break-up times and better meiboscores demonstrated greater improvements in meibomian gland yielding secretion scores.
Changes in meibomian gland yielding secretion scores were notably higher in patients with lower meiboscores and meibomian gland secretion scores before treatment.
Simplified
OBJECTIVES: To evaluate clinical changes after intense pulsed light and meibomian gland expression (/MGX) treatment in (MGD) patients, and to identify ideal candidates, and the therapeutic window, for IPL/MGX.
METHODS: This retrospective study reviewed the medical records of 44 MGD patients (44 eyes). The IPL/MGX treatment was applied on the eyelids three times at intervals of 4 weeks. Age, sex, relevant ocular history, Standard Patient Evaluation of Eye Dryness (SPEED), Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), corneal fluorescein staining score (CFSS), meiboscore, meibomian gland loss score (MGLS), meibomian glands yielding secretion score (MGYSS), meibomian glands yielding clear secretion (MGYCS), and meibomian glands yielding liquid secretion (MGYLS) were analyzed.
RESULTS: Standard Patient Evaluation of Eye Dryness, OSDI, TBUT, CFSS, MGYSS, MGYLS, and MGYCS were significantly improved after three IPL/MGX treatments, but the meiboscore and MGLS remained unchanged. In patients who had better treatment outcomes (improvement in MGYSS >7), younger age (36.0, 22.5 vs. 53.0, 25.0 years; P=0.012), a longer TBUT (8.0, 4.5 vs. 6.0, 3.0 sec; P=0.010), better meiboscore (1.0, 0.5 vs. 2.0, 1.0; P=0.012), and less gland loss (19.8%, 20.3% vs. 41.1%, 30.2%; P=0.008) before IPL/MGX were noted. Sex, relevant ocular history, SPEED, OSDI, MGYSS, MGYLS, and MGYCS before IPL/MGX showed no significant differences between patients with an improvement in MGYSS >7 versus those with an improvement of ≤7. Meibomian glands yielding secretion score changes in patients who had a meiboscore of 0 to 1 and MGYSS of 0 before IPL/MGX (12.0, 10.0) were significantly higher than those who had a meiboscore of 2 to 3 and MGYSS of 0 (6.5, 9.3; P=0.031), or a meiboscore of 0 to 1 and MGYSS >0 (5.0, 11.5; P=0.041).
CONCLUSIONS: Improved dry eye symptoms, TBUT, corneal staining, and meibomian gland secretion were observed in MGD patients after IPL/MGX. Patients in the early stages of MGD maybe benefited most from IPL/MGX treatment.
Key numbers
12.5
Decrease in SPEED Score
SPEED score decreased from (18.5, 6.0) to (6.0, 6.75)
36.0 years
Average Age of Responsive Patients
Compared to 53.0 years for nonresponsive patients
12.0
Improvement in MGYSS
Patients with MGYSS of 0 to 1 before treatment
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