Intense pulsed light therapy with meibomian gland expression for dry eye disease

Raman-Deep Singh Sambhi; Gagan Deep Singh Sambhi; Rookaya Mather; Monali S Malvankar-Mehta

doi:10.1016/j.jcjo.2019.11.009

Intense pulsed light therapy with meibomian gland expression for dry eye disease

Can J Ophthalmol. 2020 Jun;55(3):189-198. doi: 10.1016/j.jcjo.2019.11.009. Epub 2020 Jan 13.

Authors

Raman-Deep Singh Sambhi¹, Gagan Deep Singh Sambhi², Rookaya Mather³, Monali S Malvankar-Mehta⁴

Affiliations

¹ Schulich School of Medicine and Dentistry, Western University, London, Ont.
² Faculty of Medicine, University of Ottawa, Ottawa, Ont.
³ Department of Ophthalmology, Schulich School of Medicine and Dentistry, Western University, London, Ont.
⁴ Department of Ophthalmology, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ont.. Electronic address: monali.malvankar@sjhc.london.on.ca.

PMID: 31941589
DOI: 10.1016/j.jcjo.2019.11.009

Abstract

Objectives: To examine the effectiveness of intense pulsed light therapy (IPL) with meibomian gland expression (MGX) in treating meibomian gland dysfunction (MGD) and dry eye symptoms.

Design: Systematic review followed by a meta-analysis.

Methods: This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Literature sources included MEDLINE, Embase, Cochrane Library, and meeting abstracts from Canadian Ophthalmological Society, The Association for Research in Vision and Ophthalmology, The American Academy of Ophthalmology, and The European Society for Cataract and Refractive Surgeons. Articles underwent 3 stages of screening before data extraction and meta-analysis.

Results: After the initial search, 502 studies were found. Six articles were included for meta-analysis, and data were extracted after 3 stages of screening. Meta-analysis indicated significant increase in tear break-up time (TBUT) post-treatment in the <1-month follow-up (standardized mean difference [SMD] = 1.29; confidence interval [CI]: 1.10-1.48), up-to-6-month follow-up (SMD = 1.71; CI: 1.46-1.96), and >6-month follow-up (SMD = 2.04; CI: 1.68-2.40) groups. Moreover, meta-analysis suggested a nonsignificant improvement in Standardized Patient Evaluation of Eye Dryness (SPEED) scores after IPL with MGX at the <1-month follow-up (SMD = -1.35; CI: -1.70 to -1.01), up-to-6-month follow-up (SMD = -1.68; CI: -1.93 to -1.43), and >6-month follow-up (SMD = -2.04; CI: -2.40 to -1.68) groups. Meta-analysis also indicated a nonsignificant improvement in Schirmer's test values at the up-to-2-month follow-up (SMD = -0.27; CI: -0.66 to 0.12), up-to-6-month follow-up (SMD = 0.04; CI: -0.25 to 0.33), and >6-month follow-up (SMD = -0.01; CI: -0.31 to 0.28) groups.

Conclusions: The results suggested a significant increase in TBUT and a nonsignificant increase in SPEED and Schirmer's test values at all follow-up periods post-treatment. Ultimately, IPL with MGX appears to be a promising therapy for MGD.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Canada
Dry Eye Syndromes*
Humans
Intense Pulsed Light Therapy*
Meibomian Gland Dysfunction*
Meibomian Glands