Abstract
Purpose
To evaluate the combined effect of intense pulsed light (IPL) therapy and meibomian
gland expression on extracellular matrix metalloproteinase-9 (MMP-9) levels and clinical
outcomes of moderate and severe meibomian gland dysfunction (MGD) treatment.
Methods
This retrospective study was conducted on 45 eyes of 23 patients with moderate and
severe MGD. Each eye underwent three IPL sessions and meibomian gland expression at
2-week intervals. In this study the evaluated parameters included tear film break-up
time (TBUT), corneal and conjunctival fluorescein staining scores, biomicroscopic
examination of lid margins and meibomian glands, ocular surface disease index (OSDI)
questionnaire score, and extracellular MMP-9 levels using the immunoassay device before
and two weeks after the last treatment session. Linear mixed model and generalized
estimating equations model were used to evaluate possible differences.
Results
There were significant improvements in TBUT (P < 0.001), SICCA ocular staining score (P = 0.008), Oxford staining score (P = 0.023), lid margin irregularity (P < 0.001 for upper and lower eyelids), lid thickness (P < 0.001 for upper and lower eyelids), meibomian gland plugging (P = 0.010 and P = 0.012 for upper and lower eyelids), meibum color (P = 0.044 and P < 0.001 for upper and lower eyelids), meibum consistency (P < 0.001 for upper and lower eyelids), MGD grade (P < 0.001), and OSDI questionnaire score (P < 0.001). Incidence of positive results for MMP-9 immunoassay significantly decreased
from 84.0% to 56.0% (P = 0.031) after treatment.
Conclusion
In patients with moderate to severe MGD, three sessions of IPL combined with meibomian
gland expression improved objective findings, subjective symptoms, meibomian gland
function, and MMP-9 immunoassay results. The results support the combination of IPL
and meibomian gland expression for treating moderate to severe MGD.
Keywords
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Article info
Publication history
Published online: September 15, 2020
Accepted:
May 11,
2020
Received in revised form:
May 8,
2020
Received:
April 16,
2020
Identification
Copyright
© 2020 Published by Elsevier Ltd on behalf of British Contact Lens Association.
