Different Number of Sessions of Intense Pulsed Light and Meibomian Gland Expression Combination Therapy for Meibomian Gland Dysfunction
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Purpose: To evaluate the effect of the intense pulsed light (IPL) and meibomian gland (MG) expression (MGX) combinationtherapy according to the total numbers of sessions in the meibomian gland dysfunction (MGD). Methods: Ninety patients with MGD were included. Patients had maximal five sessions of IPL (Aqua Cel, Jeisys Medical)and MGX combination therapy at 2-week intervals. The ocular surface disease index (OSDI) questionnaire score, MG profilegrades, tear matrix metalloproteinase-9 (MMP-9), tear break-up time (BUT), tear osmolarity, tear secretion, and corneal erosionswere evaluated. Results: The number of patients who had a total of one to five sessions (1S to 5S) was 10, 25, 17, 20, and 18, respectively. Thetime-serial decrease of OSDI scores was significant in patients who had three or more sessions (3S, p = 0.002; 4S, p < 0.001;5S, p < 0.001). The MG expressibility grade decreased with two or more sessions (2S–5S, p < 0.001), but the meibum qualitysignificantly improved with all sessions (1S, p = 0.012; 2S, p = 0.024; 3S, p = 0.015; 4S, p < 0.001; 5S, p < 0.001). Although tearBUT increased even in patients with one session (1S, p = 0.040; 3S, p = 0.005; 4S, p = 0.006; 5S, p = 0.021), tear MMP-9, osmolarity,Schirmer I, and corneal erosions were not improved in every number of sessions. The female sex was the sole contributorto the final symptomatic improvement (p = 0.042), and the MGD stages were not related to the final OSDI decrease. Conclusions: The OSDI score, MGD grades, and BUT were improved after the IPL and MGX combination therapy in MGDpatients. Unlike MGD grades and tear film instability might be improved just after a few sessions, the overall subjective reliefwas accomplished in three or more sessions.
Abstract
Purpose: To evaluate the effect of the intense pulsed light (IPL) and meibomian gland (MG) expression (MGX) combinationtherapy according to the total numbers of sessions in the meibomian gland dysfunction (MGD). Methods: Ninety patients with MGD were included. Patients had maximal five sessions of IPL (Aqua Cel, Jeisys Medical)and MGX combination therapy at 2-week intervals. The ocular surface disease index (OSDI) questionnaire score, MG profilegrades, tear matrix metalloproteinase-9 (MMP-9), tear break-up time (BUT), tear osmolarity, tear secretion, and corneal erosionswere evaluated. Results: The number of patients who had a total of one to five sessions (1S to 5S) was 10, 25, 17, 20, and 18, respectively. Thetime-serial decrease of OSDI scores was significant in patients who had three or more sessions (3S, p = 0.002; 4S, p < 0.001;5S, p < 0.001). The MG expressibility grade decreased with two or more sessions (2S–5S, p < 0.001), but the meibum qualitysignificantly improved with all sessions (1S, p = 0.012; 2S, p = 0.024; 3S, p = 0.015; 4S, p < 0.001; 5S, p < 0.001). Although tearBUT increased even in patients with one session (1S, p = 0.040; 3S, p = 0.005; 4S, p = 0.006; 5S, p = 0.021), tear MMP-9, osmolarity,Schirmer I, and corneal erosions were not improved in every number of sessions. The female sex was the sole contributorto the final symptomatic improvement (p = 0.042), and the MGD stages were not related to the final OSDI decrease. Conclusions: The OSDI score, MGD grades, and BUT were improved after the IPL and MGX combination therapy in MGDpatients. Unlike MGD grades and tear film instability might be improved just after a few sessions, the overall subjective reliefwas accomplished in three or more sessions.
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