To evaluate the clinical efficacy and safety of combination treatment with intense pulsed light (IPL), LipiFlow thermal pulsation, and manual meibomian gland expression (MGX) for patients with refractory meibomian gland dysfunction (MGD).
A total of 23 eyes from 23 patients who underwent combination treatment with IPL, LipiFlow, and MGX for refractory MGD were included in the study. All patients were followed up for 12 months after the first treatment. All patients were examined prior to treatment and underwent three sessions of IPL, LipiFlow, and MGX, a subsequent three sessions of IPL and MGX, and six subsequent sessions of MGX. Patients were examined 10 weeks, 6 months, and 12 months after the first treatment. The ophthalmologic examination included ocular surface disease index (OSDI), non-invasive tearfilm break-up time (NIBUT), lipid layer thickness (LLT), meibomian gland expressibility (MGE), meibomian gland morphology (meiboscore), and tear meniscus height (TMH).
OSDI, NIBUT, LLT, and MGE significantly improved with treatment, which was maintained during the follow-up period. TMH and meiboscore remained unchanged throughout follow-up. No serious adverse events occurred during follow-up.
Combination therapy with IPL, LipiFlow, and MGX was clinically effective and safe for the treatment of refractory MGD. Combination treatment could be considered for patients with insufficient improvement despite conventional MGD treatments, including IPL treatment with MGX.
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We would like to sincerely thank Ms. Ji Yeon Do for her help with patient recruitment and data collection for the study.
This work was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (Grant Number: 2021R1I1A1A01052749).
Conflict of interest
The authors declare no conflicts of interest.
This study was approved by the institutional review board of the Korea National Institute for Bioethics Policy (Seoul, South Korea) (No. 2019-1108-001) and adhered to the tenets of the Declaration of Helsinki.
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Chung, H.S., Rhim, J.W. & Park, J.H. Combination treatment with intense pulsed light, thermal pulsation (LipiFlow), and meibomian gland expression for refractory meibomian gland dysfunction. Int Ophthalmol 42, 3311–3319 (2022). https://doi.org/10.1007/s10792-022-02330-5
- Meibomian gland dysfunction
- Intense pulsed light
- Thermal pulsation
- Manual meibomian gland expression