Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction

Steven J Dell,1 Ronald N Gaster,2 Sheila C Barbarino,1 Derek N Cunningham1 1Dell Laser Consultants, Austin, TX, 2Gaster Eye Center, Beverly Hills, CA, USA Purpose: The aim of this study was to estimate the efficacy of intense pulsed light (IPL), followed by meibomian gland expression (MGX), for re...

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Autores principales:	Dell SJ, Gaster RN, Barbarino SC, Cunningham DN
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Dry eye Meibomian Gland Dysfunction Intense Pulsed Light Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/4b5e57f053a1469b986285e9a0bac553
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spelling	oai:doaj.org-article:4b5e57f053a1469b986285e9a0bac5532021-12-02T00:20:14ZProspective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction1177-5483https://doaj.org/article/4b5e57f053a1469b986285e9a0bac5532017-05-01T00:00:00Zhttps://www.dovepress.com/prospective-evaluation-of-intense-pulsed-light-and-meibomian-gland-exp-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Steven J Dell,1 Ronald N Gaster,2 Sheila C Barbarino,1 Derek N Cunningham1 1Dell Laser Consultants, Austin, TX, 2Gaster Eye Center, Beverly Hills, CA, USA Purpose: The aim of this study was to estimate the efficacy of intense pulsed light (IPL), followed by meibomian gland expression (MGX), for reducing the number and severity of signs and symptoms of dry eye disease (DED) secondary to meibomian gland dysfunction (MGD). Patients and methods: In a prospective study conducted in two sites, 40 subjects (80 eyes) with moderate to severe MGD were enrolled. Major inclusion criteria consisted of at least two of the following measures being compatible with DED in both eyes: tear breakup time (TBUT), meibomian gland score (MGS), corneal fluorescein staining (CFS), Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, and tear film osmolarity (TFO). Enrolled patients underwent four treatment sessions, 3 weeks apart. Each treatment included the administration of 10–15 pulses of IPL on the cheeks and nose, followed by MGX of the upper and lower eyelids. TBUT, MGS, CFS, SPEED, TFO, and lipid layer thickness (LLT) were measured at baseline (BL) and at 9, 12, and 15 weeks after BL. Results: Due to different staining methods used for TBUT measurements, TBUT and CFS were analyzed separately for each site. From BL to the final follow-up, the number of signs compatible with DED decreased from 3.3±0.1 to 1.4±0.1. TBUT improved by +93% (n=38; P<0.0001) and +425% (n=42; P<0.0001) for sites 1 and 2, respectively. SPEED, MGS, and CFS improved by -55% (n=80; P<0.0001), -36% (n=80; P<0.0001), and -58% (n=38; P<0.0001), respectively. In 20 eyes with abnormally elevated TFO at BL, TFO improved by -7% (n=20; P<0.005). LLT did not change (n=38; P=0.88). Conclusion: In subjects with moderate to severe MGD, IPL combined with MGX reduced the number and severity of symptoms and signs of DED. Except for LLT, all examined outcome measures significantly improved after 15 weeks. These results support the efficacy of IPL + MGX in relieving both signs and symptoms of DED secondary to MGD. Keywords: dry eye, meibomian gland dysfunction, intense pulsed lightDell SJGaster RNBarbarino SCCunningham DNDove Medical PressarticleDry eyeMeibomian Gland DysfunctionIntense Pulsed LightOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 817-827 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Dry eye Meibomian Gland Dysfunction Intense Pulsed Light Ophthalmology RE1-994
spellingShingle	Dry eye Meibomian Gland Dysfunction Intense Pulsed Light Ophthalmology RE1-994 Dell SJ Gaster RN Barbarino SC Cunningham DN Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction
description	Steven J Dell,1 Ronald N Gaster,2 Sheila C Barbarino,1 Derek N Cunningham1 1Dell Laser Consultants, Austin, TX, 2Gaster Eye Center, Beverly Hills, CA, USA Purpose: The aim of this study was to estimate the efficacy of intense pulsed light (IPL), followed by meibomian gland expression (MGX), for reducing the number and severity of signs and symptoms of dry eye disease (DED) secondary to meibomian gland dysfunction (MGD). Patients and methods: In a prospective study conducted in two sites, 40 subjects (80 eyes) with moderate to severe MGD were enrolled. Major inclusion criteria consisted of at least two of the following measures being compatible with DED in both eyes: tear breakup time (TBUT), meibomian gland score (MGS), corneal fluorescein staining (CFS), Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, and tear film osmolarity (TFO). Enrolled patients underwent four treatment sessions, 3 weeks apart. Each treatment included the administration of 10–15 pulses of IPL on the cheeks and nose, followed by MGX of the upper and lower eyelids. TBUT, MGS, CFS, SPEED, TFO, and lipid layer thickness (LLT) were measured at baseline (BL) and at 9, 12, and 15 weeks after BL. Results: Due to different staining methods used for TBUT measurements, TBUT and CFS were analyzed separately for each site. From BL to the final follow-up, the number of signs compatible with DED decreased from 3.3±0.1 to 1.4±0.1. TBUT improved by +93% (n=38; P<0.0001) and +425% (n=42; P<0.0001) for sites 1 and 2, respectively. SPEED, MGS, and CFS improved by -55% (n=80; P<0.0001), -36% (n=80; P<0.0001), and -58% (n=38; P<0.0001), respectively. In 20 eyes with abnormally elevated TFO at BL, TFO improved by -7% (n=20; P<0.005). LLT did not change (n=38; P=0.88). Conclusion: In subjects with moderate to severe MGD, IPL combined with MGX reduced the number and severity of symptoms and signs of DED. Except for LLT, all examined outcome measures significantly improved after 15 weeks. These results support the efficacy of IPL + MGX in relieving both signs and symptoms of DED secondary to MGD. Keywords: dry eye, meibomian gland dysfunction, intense pulsed light
format	article
author	Dell SJ Gaster RN Barbarino SC Cunningham DN
author_facet	Dell SJ Gaster RN Barbarino SC Cunningham DN
author_sort	Dell SJ
title	Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction
title_short	Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction
title_full	Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction
title_fullStr	Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction
title_full_unstemmed	Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction
title_sort	prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/4b5e57f053a1469b986285e9a0bac553
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Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction

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