| Objective:To evaluate the effectiveness of IPL in the treatment of meibomian gland dysfunction(MGD),to analyze the effect on relevant parameters of dry eye and visual quality.To provide safer and more effective treatment method for MGD patients.Methods:The study is a series of observational studies.30 outpatients with MGD(60 eyes)in TianJin Medical University Eye Hospital from October 2017 to April 2018 were enrolled.All the subjects received IPL treatment at baseline,1 week and 3 weeks after baseline respectively,with energy of 10.6-12.2J/cm2.Before every treatment and 3months after last treatment,subjective symptoms(OSDI questionnaire,SPEED questionnaire),palpebral margin score,lipid layer thickness(LLT),blink times and proportion of incomplete blink measured by Lipiview ocular surface interferometer,tear meniscus height(TMH),non-invasive breakup time(NIBUT)and the image of meibomian gland measured by Keratograph 5M,OQAS visual quality analysis system to determine Modulation transfer functions Cut off(MTF cut off),Strehl Ratio(SR),objective scatter light index(OSI)and Mean OSI.To evaluate the effect of IPL treatment.The safety of IPL therapy was evaluated through the corrected visual acuity and intraocular pressure.Anova of repeated measurement was used to compare the differences of various indicators before and after treatment.Results:OSDI score and SPEED score of MGD patients were significantly decreased after IPL treatment(F=21.24,P<0.001;F=62.49,P<0.001),the OSDI score(33.90±15.76)of3 months after the last treatment was also significantly lower than(43.65±15.31)before the first treatment(P=0.001),and the SPEED score(8.0±3.78)was significantly lower than(11.90±2.20)before the first treatment(P<0.001).The excretion of meibum and meibomian gland secretion were significantly improved after the treatment(F=147.375,P<0.001),and 3 months after last treatment(1.95±1.08)was also improved compared to(2.73±1.19)before the treatment(P<0.001).TMH was significantly increased after IPL treatment(F=30.873,P<0.001),and TMH(0.30±0.06)mm in 3 months after last treatment was also improved compared to(0.23±0.09)mm before the first treatment(P=0.003).Noninvasive tear breakup time(NIBUTav)was prolonged after IPL treatment(F=5.047,P=0.008),and there was no significant difference between NIBUTav(8.65±4.72)s before the first treatment and(8.74±5.11)s at 3 months after the last treatment(P=0.510).The average LLT was thickened after IPL treatment(F=3.606,P=0.030),and LLT(69.97±15.76)ICU in 3 months after the last treatment was thickened than before the first treatment(63.53±18.63)ICU(P=0.010).MTF Cut off increases after IPL treatment(F=4.543,P=0.013),and MTF Cut off(32.55±9.65)in 3 months after the last treatment is unchanged compared to MTF Cut off(31.35 ±9.47)before treatment(P=0.760).SR increased after IPL treatment(P=0.001),and there was no significant difference between 3 months after the last treatment(0.19±0.04)and(0.19±0.07)before the first treatment(P=0.971).Mean objective scattering index(Mean OSI)decreased after IPL treatment(F=3.718,P=0.045),and there was no significant difference 3 months after the last treatment(1.92±1.28)and before the first treatment(1.98±1.51)(P=0.211).No significant differences were observed in the first noninvasive tear breakup time(NIBUTf),blink times,incomplete blink ratio,and OSI after IPL treatment(P=0.065,0.339,0.454,0.359).No obvious adverse reaction occurred during the IPL treatment and follow-up.No changes in corrected vision,and intraocular pressure fluctuated within the normal range.Conclusion:IPL treatment alone can improve symptoms and related indicators of dry eye in MGD patients,and the effect can last for at least 3 months.IPL is a safe and effective method in the treatment of MGD. |
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