研究目的
To study the efficacy and safety of intense pulsed light (IPL) in patients with meibomian gland dysfunction (MGD).
研究成果
IPL is effective and safe to manage patients with MGD at any stage of the disease, especially stage 4, in which other methods may have limited efficacy. IPL has an advantage in patients who lack compliance with lid hygiene and makes the improvement faster and greater magnitude than lid hygiene only.
研究不足
Although our 6-month results are promising, the true duration of the effect of IPL in patients with MGD is still unknown. Studies with a longer follow-up are needed. Another future direction may be to determine how many IPL sessions are needed for different stages of the disease. Another study limitation was that the time between tear collection and cytokine analysis might have affected the cytokine levels. Thus, our study might not present the true effect of IPL on these cytokines. We excluded patients who wore contact lenses, who had recently undergone eye surgery, and who were being treated with antiglaucoma eye drops. MGD is also prevalent among these patients. Excluding these patients may limit the applicability of IPL treatment. Moreover, the patients were all restricted to a Thai population.
1：Experimental Design and Method Selection
Prospective randomized double-masked sham-controlled trial. Patients were randomized into the IPL or sham group. Either the IPL or sham procedure was performed on days 0, 15, and 45.
2：Sample Selection and Data Sources
114 patients with MGD were consecutively enrolled from the eye clinic, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Thailand, from August 2018 to March 2019.
3：List of Experimental Equipment and Materials
IPL [E.Eye (E-SWIN, Paris, France)], TearLab Osmolarity System (Escondido, CA), LipiView II Ocular Surface Interferometer (TearScience), Keratograph 5M (Oculus, Wetzlar, Germany), Bio-Plex 200 system (Bio-Rad, Hercules, CA).
4：Experimental Procedures and Operational Workflow
Patients in both groups wore opaque goggles over their eyes, and cooling gel was spread over the skin below the inferior lid margin from the inner canthus toward the lateral canthus. For both groups, the IPL tip was placed below the inferior lid margin divided into 5 areas according to the company’s recommendations. Then, IPL treatment began for a total of 1 pass on each eye.
5：Data Analysis Methods
A multilevel mixed-effect linear regression model was used for the OSDI score, VAS, UCVA, BCVA, TFLLT, meibography grade, TBUT, ocular surface staining score, meibum quality score, meibum expressibility score, Schirmer test, tear osmolarity, and pain score immediately after IPL. Linear regression analysis was used for cytokine comparison.
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