Combination Therapy of Intense Pulsed Light Therapy and Meibomian Gland Expression (IPL/MGX) Can Improve Dry Eye Symptoms and Meibomian Gland Function in Patients With Refractory Dry Eye: A Retrospective Analysis
Purpose: To assess the improvement in meibomian gland function and dry eye symptoms in patients with refractory dry eye treated with a combination therapy of intense pulsed light (IPL) and meibomian gland expression (MGX) Methods: Medical records of 81 consecutive patients with dry eye treated with serial IPL/MGX were retrospectively examined to determine the outcome. All patients had a minimum of 6 months of follow up after the first IPL/MGX treatment. Patients typically received 1 to 4 IPL treatments spaced 4 to 6 weeks apart. Each IPL session included MGX. Thirty five charts had complete data for inclusion in analysis. We reviewed demographics, ocular histories, Standard Patient Evaluation of Eye Dryness 2 (SPEED2) symptom survey scores, slit lamp examinations, and meibomian gland evaluations (MGE) at baseline and at each visit before IPL/MGX treatments. Results: The paired t test showed a significant (P 0.0001) decrease in SPEED2 with IPL/MGX therapy. Of the 35 patients, 8 (23% had a =50% decrease in SPEED2, 23 (66% had a 1% to 49% decrease in SPEED2, 1 (3% had no change in SPEED2, and 3 (9% had an increase in SPEED2. The Paired t test showed a significant increase in MGE in the left eye but not in the right eye (OD P 0.163 and OS P 0.0002) Thirteen patients (37% had improved MGE bilaterally. Eight patients (23% had either a decrease in MGE bilaterally or a decrease in 1 eye with no change in the other eye. Conclusions: This retrospective analysis shows that the combination of IPL and MGX can significantly improve dry eye symptoms (in 89% of patients) and meibomian gland function (in 77% of patients in at least 1 eye)
Cornea