Skip to main content
SpringerLink
Log in

Intense pulsed light (IPL) therapy for meibomian gland dysfunction (MGD)–related dry eye disease (DED): a systematic review and meta-analysis

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

To compare the effect of intense pulsed light (IPL) therapy and conventional treatments in meibomian gland dysfunction (MGD)–related dry eye disease (DED). A literature search was conducted in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP, and China Biology Medicine (CBM) up to January 2022. Randomized controlled trials (RCTs) were included. Mean differences (MDs) and their 95% confidence intervals (CIs) were calculated. A meta-analysis concerning changes in tear break-up time (BUT), changes in Ocular Surface Disease Index (OSDI) scores, changes in non-invasively measured tear break‐up time (NIBUT), changes in corneal and conjunctival fluorescein staining (CFS) scores, and changes in Standard Patient Evaluation of Eye Dryness (SPEED) scores was carried out. The initial search identified a total of 1842 records in the databases, and 11 studies were included in the final analysis. Compared to conventional therapies, IPL therapy was associated with significantly reduced OSDI (MD, − 7.49; 95% CI, − 12.47 to − 2.5) and SPEED (MD, − 3.28; 95% CI, − 5.64 to − 0.93) scores, while BUT (MD, 1.94; 95% CI, 1.19 ~ 2.69) and NIBUT (MD, 2.55; 95% CI, 1.07 ~ 4.04) significantly increased. No significant difference was found in the change in CFS between the two groups. Both IPL treatment and traditional treatments are effective in the treatment of MGD-related DED. IPL application seems to be superior to traditional treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data availability

The data collected to support the findings of this study are included within the article.

References

  1. Geerling G, Tauber J, Baudouin C, Goto E, Matsumoto Y, O’Brien T, Rolando M, Tsubota K et al (2011) The international workshop on meibomian gland dysfunction: report of the subcommittee on management and treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci 52:2050–2064. https://doi.org/10.1167/iovs.10-6997g

    Article  PubMed  PubMed Central  Google Scholar 

  2. No authors listed (2007) The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 5:75–92. https://doi.org/10.1016/s1542-0124(12)70081-2

    Article  Google Scholar 

  3. Nelson JD, Shimazaki J, Benitez-del-Castillo JM, Craig JP, McCulley JP, Den S, Foulks GN (2011) The international workshop on meibomian gland dysfunction: report of the definition and classification subcommittee. Invest Ophthalmol Vis Sci 52:1930–1937. https://doi.org/10.1167/iovs.10-6997b

    Article  PubMed  PubMed Central  Google Scholar 

  4. Raulin C, Greve B, Grema H (2003) IPL technology: a review. Lasers Surg Med 32:78–87. https://doi.org/10.1002/lsm.10145

    Article  PubMed  Google Scholar 

  5. Wat H, Wu DC, Rao J, Goldman MP (2014) Application of intense pulsed light in the treatment of dermatologic disease: a systematic review. Dermatol Surg : Off Publ Am Soc Dermatol Surg [et al] 40:359–377. https://doi.org/10.1111/dsu.12424

    Article  CAS  Google Scholar 

  6. Toyos R, McGill W, Briscoe D (2015) Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retrospective study. Photomed Laser Surg 33:41–46. https://doi.org/10.1089/pho.2014.3819

    Article  PubMed  PubMed Central  Google Scholar 

  7. Arita R, Fukuoka S, Mizoguchi T, Morishige N (2020), Multicenter study of intense pulsed light for patients with refractory aqueous-deficient dry eye accompanied by mild meibomian gland dysfunction. Journal of clinical medicine 9https://doi.org/10.3390/jcm9113467

  8. Craig JP, Chen YH, Turnbull PR (2015) Prospective trial of intense pulsed light for the treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci 56:1965–1970. https://doi.org/10.1167/iovs.14-15764

    Article  PubMed  Google Scholar 

  9. Wladis EJ, Aakalu VK, Foster JA, Freitag SK, Sobel RK, Tao JP, Yen MT (2020) Intense pulsed light for meibomian gland disease: a report by the American Academy of Ophthalmology. Ophthalmol 127:1227–1233. https://doi.org/10.1016/j.ophtha.2020.03.009

    Article  Google Scholar 

  10. Liu S, Tang S, Dong H, Huang X (2020) Intense pulsed light for the treatment of meibomian gland dysfunction: a systematic review and meta-analysis. Exp Ther Med 20:1815–1821. https://doi.org/10.3892/etm.2020.8838

    Article  PubMed  PubMed Central  Google Scholar 

  11. Leng X, Shi M, Liu X, Cui J, Sun H, Lu X (2021) Intense pulsed light for meibomian gland dysfunction: a systematic review and meta-analysis. Graefe’s Arch Clin Exp Ophthalmol 259:1–10. https://doi.org/10.1007/s00417-020-04834-1

    Article  Google Scholar 

  12. Cote S, Zhang AC, Ahmadzai V, Maleken A, Li C, Oppedisano J, Nair K, Busija L et al (2020) Intense pulsed light (IPL) therapy for the treatment of meibomian gland dysfunction. Cochrane Database Syst Rev 3:013559. https://doi.org/10.1002/14651858.Cd013559

    Article  Google Scholar 

  13. Sambhi RS, Sambhi GDS, Mather R, Malvankar-Mehta MS (2020) Intense pulsed light therapy with meibomian gland expression for dry eye disease. Can J Ophthalmol J Can d’ophtalmol 55:189–198. https://doi.org/10.1016/j.jcjo.2019.11.009

    Article  Google Scholar 

  14. Higgins JPT, Li T, Deeks JJ (2022) Chapter 6: Choosing effect measures and computing estimates of effect. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (eds) Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane. www.training.cochrane.org/handbook

  15. Piyacomn Y, Kasetsuwan N, Reinprayoon U, Satitpitakul V, Tesapirat L (2020) Efficacy and safety of intense pulsed light in patients with meibomian gland dysfunction-a randomized, double-masked, sham-controlled clinical trial. Cornea 39:325–332. https://doi.org/10.1097/ico.0000000000002204

    Article  PubMed  Google Scholar 

  16. Xiao Y, Yin HB, Zhang YY, Deng YP (2021) Evaluation of short-term effect of E-eye intense pulsed light combined with meibomian gland expression in the treatment of meibomian gland dysfunction. Guoji Yanke Zazhi (Int Eye Sci) 21:124–131

    Google Scholar 

  17. Yan X, Hong J, Jin X, Chen W, Rong B, Feng Y, Huang X, Li J et al (2021) The efficacy of intense pulsed light combined with meibomian gland expression for the treatment of dry eye disease due to meibomian gland dysfunction: a multicenter, randomized controlled trial. Eye Contact Lens 47:45–53. https://doi.org/10.1097/icl.0000000000000711

    Article  PubMed  Google Scholar 

  18. Zarei-Ghanavati S, Hassanzadeh S, Azimi Khorasani A, Ehsaei A, Bakhtiari E (2021), Efficacy of five-flash intense pulsed light therapy technique in patients with meibomian gland dysfunction. Clin Exp Optometry:1–7. https://doi.org/10.1080/08164622.2021.1976595

  19. Ren X, Chou Y, Wang Y, Chen Y, Liu Z, Li X (2021) Comparison of intense pulsed light and near-infrared light in the treatment of dry eye disease: a prospective randomized study. Acta Ophthalmol 99:e1307–e1314. https://doi.org/10.1111/aos.14833

    Article  PubMed  Google Scholar 

  20. Arita R, Fukuoka S, Morishige N (2019) Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction. Ocul Surf 17:104–110. https://doi.org/10.1016/j.jtos.2018.11.004

    Article  PubMed  Google Scholar 

  21. Li L, Li JC, Chen J (2018) Observation and nursing of the therapeutic effect of OPT Laser in the treatment of blepharal gland dysfunction. China Contin Med Educ 10:3

    Google Scholar 

  22. Dai PF, Li Y, Tian F, Wang YQ, Ni SS, Wang J (2019) Efficacy comparison of intense pulsed light combined with meibomian gland massage and eyelid fumigation massage in the treatment of MGD-related dry eyes. Guoji Yanke Zazhi (Int Eye Sci) 19:2101–2106

    Google Scholar 

  23. Gao YF, Liu RJ, Li YX, Huang C, Liu YY, Hu CX, Qi H (2019) Comparison of anti-inflammatory effects of intense pulsed light with tobramycin/dexamethasone plus warm compress on dry eye associated meibomian gland dysfunction. Int J Ophthalmol 12:1708–1713. https://doi.org/10.18240/ijo.2019.11.07

    Article  PubMed  PubMed Central  Google Scholar 

  24. Wang Y, Niu H, Zhang X (2020) Clinical efficacy of intense pulsed light (IPL) combined with meibomian gland expression in the treatment of dry eyes related to meibomian gland dysfunction (MGD). Diet Health 47:48

  25. Song Y, Yu S, He X, Yang L, Wu Y, Qin G, Zhang Q, Deep Singh Talwar G, et al. (2021), Tear film interferometry assessment after intense pulsed light in dry eye disease: a randomized, single masked, sham-controlled study. Contact lens & anterior eye : the journal of the British Contact Lens Association:101499. https://doi.org/10.1016/j.clae.2021.101499.

  26. Ozcura F, Aydin S, Helvaci MR (2007) Ocular surface disease index for the diagnosis of dry eye syndrome. Ocul Immunol Inflamm 15:389–393. https://doi.org/10.1080/09273940701486803

    Article  PubMed  Google Scholar 

  27. Sweeney DF, Millar TJ, Raju SR (2013) Tear film stability: a review. Exp Eye Res 117:28–38. https://doi.org/10.1016/j.exer.2013.08.010

    Article  CAS  PubMed  Google Scholar 

  28. Zhang X, Song N, Gong L (2019) Therapeutic effect of intense pulsed light on ocular demodicosis. Curr Eye Res 44:250–256. https://doi.org/10.1080/02713683.2018.1536217

    Article  CAS  PubMed  Google Scholar 

  29. Prieto VG, Sadick NS, Lloreta J, Nicholson J, Shea CR (2002) Effects of intense pulsed light on sun-damaged human skin, routine, and ultrastructural analysis. Lasers Surg Med 30:82–85. https://doi.org/10.1002/lsm.10042

    Article  PubMed  Google Scholar 

  30. Schroeter CA, Haaf-von Below S, Neumann HA (2005) Effective treatment of rosacea using intense pulsed light systems. Dermatol Surg 31:1285–1289. https://doi.org/10.1111/j.1524-4725.2005.31204

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Yahui Lei and Jing Peng made equal contributions in this article.

Authors and Affiliations

  1. Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China

    Yahui Lei, Jiayan Liu & Jingxiang Zhong

  2. Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China

    Jing Peng

  3. The Sixth Affiliated Hospital of Jinan University, Jinan University, Dongguan, China

    Jingxiang Zhong

Authors
  1. Yahui Lei
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jing Peng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jiayan Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jingxiang Zhong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jingxiang Zhong.

Ethics declarations

Ethics approval

No ethical approval is needed.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lei, Y., Peng, J., Liu, J. et al. Intense pulsed light (IPL) therapy for meibomian gland dysfunction (MGD)–related dry eye disease (DED): a systematic review and meta-analysis. Lasers Med Sci 38, 1 (2023). https://doi.org/10.1007/s10103-022-03690-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10103-022-03690-1

Keywords

Search

Navigation