Effect of IPL in Patients with Meibomian Gland Dysfunction

Abstract

Purpose To evaluate the effect of IPL (intense pulsed light) treatment in patients with meibomian gland dysfunction (MGD).

Methods Clinical data of 25 patients with MGD who underwent IPL treatment at the department of ophthalmology of Ludwig-Maximilians-University between 2016 and 2018 were analyzed. Demographics, clinical history, examination findings (eyelid vascularization, meibomian gland findings, conjunctival redness, tear film break-up time [TFBUT], corneal staining (Oxford grading scale [OGS]), and subjective patientsʼ findings (including ocular surface disease index [OSDI]) were collected from each visit (D1, D15, D45, D75).

Results All included patients underwent three sessions of IPL treatment in both eyes (D1, D15, D45). There was a significant improvement after IPL treatment (D75) in TFBUT (p < 0.001), corneal staining (OGS) (p < 0.001), conjunctival redness (p < 0.001), lid margin edema (p < 0.001) and redness (p < 0.001), meibum quality (p < 0.001), lid margin telangiectasia (p = 0.005), meibomian gland obstruction (p = 0.001), and OSDI score (p = 0.004). Even after the first IPL session, significant improvements in TFBUT (p < 0.001), corneal staining (OGS p < 0.001), conjunctival redness (p < 0.022), lid margin edema (p < 0.001) and redness (p < 0.016), meibum quality (p = 0.014), and OSDI score (p < 0.013) were noted. There were no relevant negative side effects. Subgroup analysis for age, sex, duration or severity of disease, and associated diagnosis of rosacea showed no significant difference in effectiveness.

Conclusion IPL is an effective and safe treatment for patients with MGD, which can be used as a supportive therapeutic option.

Zusammenfassung

Ziel Beurteilung der Wirkung der IPL-Therapie (IPL: Intensive pulsed Light) bei Patienten mit Meibomdrüsendysfunktion (MDD).

Methoden Analysiert wurden die Daten von 25 Patienten mit MDD, die zwischen 2016 und 2018 in der Abteilung für Augenheilkunde der LMU mittels IPL behandelt wurden. Demografische Daten, klinische Anamnese sowie Untersuchungsbefunde (Lidrandvaskularisation, Meibomdrüsenbefunde, Bindehautrötung, Tränenfilmaufrisszeit (TFBUT), Hornhautoberflächenfärbung (Oxford Grading Scale [OGS]) und subjektive Symptome (einschließlich des Ocular Surface Disease Index [OSDI]) wurden bei jedem Besuch erhoben (D1, D15, D45, D75).

Ergebnisse Alle Patienten erhielten eine IPL-Behandlung in 3 Sitzungen an beiden Augen (D1, D15, D45). Am Ende der IPL-Behandlung (D75) zeigte sich eine signifikante Verbesserung von TFBUT (p < 0,001), Hornhautoberflächenfärbung (OGS) (p < 0,001), Bindehautrötung (p < 0,001), Lidrandödem (p < 0,001) und Lidrandrötung (p < 0,001), Meibumqualität (p < 0,001), Lidrandteleangiektasien (p = 0,005), Meibomdrüsenobstruktion (p = 0,001) und OSDI-Score (p = 0,004). Bereits nach der 1. IPL-Sitzung konnte eine signifikante Verbesserung von TFBUT (p = 0,001), Hornhautoberflächenfärbung (OGS p < 0,001), Bindehautrötung (p = 0,022), Lidrandödem (p = 0,001) und -rötung (p = 0,016), Meibumqualität (p = 0,014) und OSDI-Score (p = 0,013) festgestellt werden. Es gab keine relevanten negativen Nebenwirkungen. Eine Subgruppenanalyse hinsichtlich Alter, Geschlecht, Dauer oder Schwere der Erkrankung sowie der assoziierten Diagnose der Rosazea zeigte keinen signifikanten Unterschied in der Wirksamkeit.

Schlussfolgerung IPL ist eine wirksame und sichere Behandlung für Patienten mit MGD, die als unterstützende therapeutische Option eingesetzt werden kann.

Key words

IPL - Meibomian gland dysfunction - dry eye - light impulse - intensive pulsed light

Schlüsselwörter

IPL - Meibomdrüsendysfunktion - trockenes Auge - Pulslichttherapie - Intensive pulsed Light

Publikationsverlauf

Eingereicht: 09. September 2020

Angenommen: 14. November 2020

Artikel online veröffentlicht:
04. Februar 2021

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