Randomised double-masked placebo-controlled trial of the cumulative treatment efficacy profile of intense pulsed light therapy for meibomian gland dysfunction.
PURPOSE
To assess long-term cumulative treatment effects of intense pulsed light (IPL) therapy in meibomian gland dysfunction (MGD).


METHODS
Eighty-seven symptomatic participants (58 female, mean ± SD age, 53 ± 16 years) with clinical signs of MGD were enrolled in a prospective, double-masked, parallel-group, randomised, placebo-controlled trial. Participants were randomised to receive either four or five homogeneously sequenced light pulses or placebo treatment to both eyes, (E-Eye Intense Regulated Pulsed Light, E-Swin, France). Visual acuity, dry eye symptomology, tear film parameters, and ocular surface characteristics were assessed immediately before treatment on days 0, 15, 45, 75, and four weeks after treatment course completion on day 105. Inflammatory and goblet cell function marker expression, and eyelid swab microbiology cultures were evaluated at baseline and day 105.


RESULTS
Significant decreases in OSDI, SPEED, and SANDE symptomology scores, and meibomian gland capping, accompanied by increased tear film lipid layer thickness, and inhibited Corynebacterium macginleyi growth were observed in both treatment groups (all p < 0.05). Sustained clinical improvements occurred in both treatment groups from day 75, although significant changes from day 45, in lipid layer quality, meibomian gland capping, OSDI and SANDE symptomology, were limited to the five-flash group (all p < 0.05).


CONCLUSIONS
IPL therapy effected significant improvements in dry eye symptomology, tear film lipid layer thickness, and meibomian gland capping in MGD patients. Five-flash IPL treatment showed superior clinical efficacy to four-flash, and an initial course of at least four treatments is suggested to allow for establishment of sustained cumulative therapeutic benefits prior to evaluation of overall treatment efficacy.


TRIAL REGISTRATION NUMBER
ACTRN12616000667415.
['Xue|Ally L|AL|', 'Wang|Michael T M|MTM|', 'Ormonde|Susan E|SE|', 'Craig|Jennifer P|JP|']
D000328:Adult D000368:Aged D003352:Corynebacterium D015352:Dry Eye Syndromes D005141:Eyelid Diseases D005260:Female D005602:France D006801:Humans D062325:Intense Pulsed Light Therapy D008297:Male D000080343:Meibomian Gland Dysfunction D008537:Meibomian Glands D008875:Middle Aged D011446:Prospective Studies D013666:Tears D016896:Treatment Outcome
Intense pulsed light Meibomian gland Dry eye Tear film Ocular surface Lipid layer