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Combination treatment with intense pulsed light, thermal pulsation (LipiFlow), and meibomian gland expression for refractory meibomian gland dysfunction

International Ophthalmology volume 42, pages 3311–3319 (2022)Cite this article

Abstract

Purpose

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).

Methods

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).

Results

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.

Conclusions

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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Availability of data and materials

The data used in this study are available from the corresponding author upon request.

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Acknowledgements

We would like to sincerely thank Ms. Ji Yeon Do for her help with patient recruitment and data collection for the study.

Funding

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).

Author information

Author notes

  1. Ho Seok Chung and Jae Won Rhim have contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea

    Ho Seok Chung

  2. Miso Eye Clinic, 5th floor 310, Wiryegwangjang-ro, Sujeong-gu, Seongnam-si, Gyeonggi-do, South Korea

    Jae Won Rhim & Jin Hyoung Park

  3. Research Institute for Biomacromolecules, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea

    Jin Hyoung Park

Authors
  1. Ho Seok Chung
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by HSC, JWR, and JHP. The first draft of the manuscript was written by HSC, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jin Hyoung Park.

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Conflict of interest

The authors declare no conflicts of interest.

Ethics approval

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

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  • DOI: https://doi.org/10.1007/s10792-022-02330-5

Keywords

  • Meibomian gland dysfunction
  • Intense pulsed light
  • Thermal pulsation
  • Manual meibomian gland expression