Journal of Shandong University (Health Sciences) ›› 2024, Vol. 62 ›› Issue (4): 54-60.doi: 10.6040/j.issn.1671-7554.0.2024.0148

• Clinical Medicine • Previous Articles    

Effects of intense pulsed light on the meibomian gland and tear film lipid layer in patients with lipid deficiency dry eye disease

ZHANG Qichen1, KANG Suifang1, YIN Chuanjie2, XIAO Juan3, MA Guangfeng1, CAO Yuan1, CHEN Guoling1   

  1. 1. Department of Ophthalmology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China;
    2. Department of Ophthalmology, Qingdao Eighth Peoples Hospital, Qingdao 266100, Shandong, China;
    3. Department of Hospital Infection Management, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2024-05-16

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Abstract: Objective To observe the effects of intense pulsed light(IPL)on the meibomian gland and tear film lipid layer in patients with lipid deficiency dry eye disease. Methods A total of 60 patients(120 eyes)with lipid deficiency dry eye disease were divided into control group(60 eyes)and IPL group(60 eyes)using random numbers. Before and after 6 weeks of treatment, non-invasive breakup time(NIBUT), ocular surface disease index(OSDI)questionnaire, and corneal fluorescein staining(CFS)were assessed to evaluate the indicators of dry eye disease. The Oculus Keratograph analyzer and meibomian gland evaluator(MGE)were used to determine the meibomian gland dropout score(MGDS), meibomian gland yielding liquid secretion(MGLYS)and meibomian gland yielding secretion score(MGYSS)to assess the meibomian gland. The LipiView interferometer was used to evaluate the tear film lipid layer thickness(LLT). Results No statistically significant differences were observed between the two groups before treatment. Compared with baseline, NIBUT, OSDI, CFS, MGLYS, MGYSS and LLT were improved in both groups after treatment(all P<0.001), while there was no significant difference in MGDS. Except MGDS, the other parameters in the IPL group were improved better than those in control group after treatment(PNIBUT=0.031, POSDI=0.023, PCFS=0.014, PMGLYS=0.020, PMGLYS=0.023, PLLT=0.004). No adverse reactions occurred during the treatment. Conclusion IPL could improve the function of meibomian gland and the thickness of tear film lipid layer; it is an effective and safe treatment for patients with lipid deficiency dry eye disease.

Key words: Lipid deficiency dry eye disease, Intense pulsed light, Meibomian gland, Tear film stability, Ocular surface disease

CLC Number: 

  • R777.1+3
[1] Stapleton F, Alves M, Bunya VY, et al. TFOS DEWS II epidemiology report[J]. Ocul Surf, 2017, 15(3): 334- 365.
[2] 亚洲干眼协会中国分会,海峡两岸医药卫生交流协会眼科学专业委员会眼表与泪液病学组,中国医师协会眼科医师分会眼表与干眼学组. 中国干眼专家共识: 定义和分类(2020年)[J]. 中华眼科杂志, 2020, 56(6): 418-422.
[3] 亚洲干眼协会中国分会, 海峡两岸医药卫生交流协会眼科学专业委员会眼表与泪液病学组, 中国医师协会眼科医师分会眼表与干眼学组. 中国干眼专家共识: 治疗(2020年)[J]. 中华眼科杂志, 2020, 56(12): 907-913.
[4] 亚洲干眼协会中国分会,海峡两岸医药卫生交流协会眼科学专业委员会眼表与泪液病学组,中国医师协会眼科医师分会眼表与干眼学组. 中国干眼专家共识: 检查和诊断(2020年)[J]. 中华眼科杂志, 2020, 56(10): 741-747.
[5] 亚洲干眼协会中国分会, 海峡两岸医药交流协会眼科专业委员会眼表与泪液病学组. 我国睑板腺功能障碍诊断与治疗专家共识(2017年)[J]. 中华眼科杂志, 2017, 53(9): 657-661.
[6] 干眼强脉冲光临床应用专家共识专家组, 中国康复医学会视觉康复专委会干眼康复专业组. 强脉冲光治疗睑板腺功能障碍及其相关干眼专家共识(2022)[J]. 中华实验眼科杂志, 2022, 40(2): 97-103. Chinese Experts Consensus Group of Intense Pulsed Light for Dry Eye, Dry Eye Rehabilitation Specialty, Visual Rehabilitation Committee of Chinese Rehabilitation Medicine Association. Experts consensus on intense pulsed light for meibomian gland dysfunction and related dry eye(2022)[J]. Chin J Exp Ophthalmol, 2022, 40(2): 97-103.
[7] Toyos R, McGill W, Briscoe D. Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retrospective study[J]. Photomed Laser Surg, 2015, 33(1): 41-46.
[8] Wolffsohn JS, Arita R, Chalmers R, et al. TFOS DEWS II Diagnostic Methodology report[J]. Ocul Surf, 2017, 15(3): 539-574.
[9] Schiffman RM, Christianson MD, Jacobsen G, et al. Reliability and validity of the ocular surface disease index[J]. Arch Ophthalmol, 2000, 118(5): 615-621.
[10] 中华医学会眼科学分会角膜病学组.干眼临床诊疗专家共识(2013年)[J]. 中华眼科杂志, 2013, 49(1): 73-75. Corneal Disease Group of Ophthalmological Society, Chinese Medical Association. Experts consensus about clinical diagnosis and treatment of dry eye(2013)[J]. Chin J Ophthalmol, 2013, 49(1): 73-75.
[11] Tomlinson A, Bron AJ, Korb DR, et al. The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee[J]. Invest Ophthalmol Vis Sci, 2011, 52(4): 2006-2049.
[12] Green-Church KB, Butovich I, Willcox M, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on tear film lipids and lipid-protein interactions in health and disease[J]. Invest Ophthalmol Vis Sci, 2011, 52(4): 1979-1993.
[13] 亚洲干眼协会中国分会, 海峡两岸医药卫生交流协会眼科学专业委员会眼表与泪液病学组, 中国医师协会眼科医师分会眼表与干眼学组. 中国睑板腺功能障碍专家共识: 定义和分类(2023年)[J]. 中华眼科杂志, 2023, 59(4): 256-261. Chinese Branch of the Asian Dry Eye Society, Ocular Surface and Tear Film Diseases Group of Ophthalmology Committee of Cross-Straits Medicine Exchange Association, Ocular Surface and Dry Eye Group of Chinese Ophthalmologist Association. Chinese expert consensus on meibomian gland dysfunction: definition and classification(2023)[J]. Chin J Ophthalmol, 2023, 59(4): 256-261.
[14] 范先群, 赵勘兴, 杨培增. 眼科学[M]. 9版. 北京: 人民卫生出版社, 2018.
[15] 张京京, 陈国玲, 鲍印磊, 等. Oculus Keratograph分析仪评估睑板腺功能障碍患者的眼表情况[J]. 山东大学学报(医学版), 2020, 58(6): 87-91. ZHANG Jingjing, CHEN Guoling, BAO Yinlei, et al. Oculus Keratograph in the evaluation of ocular surface in patients with meibomian gland dysfunction[J]. Journal of Shandong University(Health Science), 2020, 58(6): 87-91.
[16] Nelson JD, Shimazaki J, Benitez-del-Castillo JM, et al. The international workshop on meibomian gland dysfunction: report of the definition and classification subcommittee[J]. Invest Ophthalmol Vis Sci, 2011, 52(4): 1930-1937.
[17] 亚洲干眼协会中国分会,海峡两岸医药卫生交流协会眼科学专业委员会眼表与泪液病学组,中国医师协会眼科医师分会眼表与干眼学组. 中国睑板腺功能障碍专家共识: 诊断和治疗(2023年)[J]. 中华眼科杂志, 2023, 59(11): 880-887. Chinese Branch of the Asian Dry Eye Society, Ocular Surface and Tear Film Diseases Group of Ophthalmology Committee of Cross-Straits Medicine Exchange Association, Ocular Surface and Dry Eye Group of Chinese Ophthalmologist Association. Chinese expert consensus on meibomian gland dysfunction: diagnosis and management(2023)[J]. Chin J Ophthalmol, 2023, 59(11): 880-887.
[18] Wanitphakdeedecha R, Tavechodperathum N, Tantrapornpong P, et al. Acne treatment efficacy of intense pulsed light photodynamic therapy with topical licochalcone A, l-carnitine, and decanediol: a spilt-face, double-blind, randomized controlled trial[J]. J Cosmet Dermatol, 2020, 19(1): 78-87.
[19] 范梦娇, 何勤, 罗青, 等. 反射式共聚焦显微镜观察强脉冲光治疗红斑毛细血管扩张型玫瑰痤疮的效果[J]. 山东大学学报(医学版), 2022, 60(4): 87-90. FAN Mengjiao, HE Qin, LUO Qing, et al. Effects of intense pulsed light on erythema telangiectasia rosacea observed with reflection confocal microscope[J]. Journal of Shandong University(Health Science), 2022, 60(4): 87-90.
[20] Vergés C, March DRF, Salgado-Borges J, et al. Prospective evaluation of intense pulsed light treatment for meibomian gland dysfunction and blepharitis due to ocular rosacea[J]. Eur J Dermatol, 2022, 32(4): 505-515.
[21] Bennardo L, Patruno C, Zappia E, et al. Combination of specific vascular lasers and vascular intense pulsed light improves facial telangiectasias and redness[J]. Medicina(Kaunas), 2022, 58(5): 651. doi: 10.3390/medicina 58050651.
[22] Choi M, Han SJ, Ji YW, et al. Meibum expressibility improvement as a therapeutic target of Intense pulsed light treatment in meibomian gland dysfunction and its association with tear inflammatory cytokines[J]. Sci Rep, 2019, 9(1): 7648. doi: 10.1038/s41598-019-44000-0.
[23] Li Q, Liu J, Liu C, et al. Effects of intense pulsed light treatment on tear cytokines and clinical outcomes in meibomian gland dysfunction[J]. PLoS One, 2021, 16(8): e0256533. doi: 10.1371/journal.pone.0256533.
[24] Sambhi RS, Sambhi G, Mather R, et al. Intense pulsed light therapy with meibomian gland expression for dry eye disease[J]. Can J Ophthalmol, 2020, 55(3): 189-198.
[25] Yin Y, Liu N, Gong L, et al. Changes in the meibomian gland after exposure to intense pulsed light in meibomian gland dysfunction(MGD)patients[J]. Curr Eye Res, 2018, 43(3): 308-313.
[26] Mejía LF, Gil JC, Jaramillo M. Intense pulsed light therapy: a promising complementary treatment for dry eye disease[J]. Arch Soc Esp Oftalmol(Engl Ed), 2019, 94(7): 331-336.
[27] Arita R, Fukuoka S, Morishige N. Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction[J]. Ocul Surf, 2019, 17(1): 104-110.
[28] 安琳, 韦秋红, 曾悦, 等. 优化脉冲光辅助治疗蠕形螨相关鳞屑性睑缘炎的疗效及对眼表状态的影响[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 77-82. AN Lin, WEI Qiuhong, ZENG Yue,et al. Optimization of the effect of pulsed light in the treatment of demodex-associated squamous blepharitis and its effect on ocular surface function and corneal cell density[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(3): 77-82.
[29] Lee JM, Jeon YJ, Kim KY, et al. Ocular surface analysis: a comparison between the LipiView(®)II and IDRA(®)[J]. Eur J Ophthalmol, 2021, 31(5): 2300-2306.
[30] Marta A, Baptista PM, Heitor MJ, et al. Intense pulsed plus low-level light therapy in meibomian gland dysfunction[J]. Clin Ophthalmol, 2021, 15: 2803-2811. doi: 10.2147/OPTH.S318885.
[1] FAN Mengjiao, HE Qin, LUO Qing, WANG Zhenhua. Effects of intense pulsed light on erythema telangiectasia rosacea observed with reflection confocal microscope [J]. Journal of Shandong University (Health Sciences), 2022, 60(4): 87-90.
[2] ZHANG Jingjing, CHEN Guoling, BAO Yinlei, MA Guangfeng. Oculus Keratograph in the evaluation of ocular surface in patients with meibomian gland dysfunction [J]. Journal of Shandong University (Health Sciences), 2020, 58(6): 87-91.
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