Treatment Of Meibomian Gland Dysfunction Using Intensive Pulse Light

Evaluation of the efficacy of Lumenis M22 with Intensive Pulse Light in the treatment of dry eye syndrome due to meibomian gland dysfunction of various degrees.

Clinical studies were conducted at the SIHAT KOZ eye clinic, Tashkent, Uzbekistan. The study included patients with myopic refraction admitted for keratorefractive laser surgery.

We observed 60 patients (120 eyes) with dry eye syndrome. Among them there were 36 women (60%), men - 24 (40%), whose average age was 38.2±5.67. meibomian gland dysfunction grade I was detected in 22 patients (44 eyes, 36%) cases, grade II - in 20 (40 eyes, 34%), and grade III - in 18 (36 eyes, 30%) of the examined patients. The therapeutic course consisted on average of 4 procedures of Intensive Pulse Light therapy of the periorbital zone, followed by massage of the edges of the eyelids, carried out with a break once every 3 weeks. During the procedure, the “Vascular lesions” mode was used, a filter with a wavelength of 560-590 nm, the pulse duration was 6 ms. The duration of the procedure is short, usually 20 minutes.

There was a significant increase in the mean values of the non-invasive tear break up time: 1.5 times in the grade I, 1.6 times in the grade II and 2.3 times in the grade III. The lipid layer increased by 14 nm (p <0.05) in patients with meibomian gland dysfunction grade I, by 17 and 20 nm (p <0.01) respectively with grades II and III. The patients change in the control group were also positive, but they were statistically insignificant (p> 0.05). The study of meibography also revealed a positive dynamic: the meibomian gland loss before treatment averaged 28.3% in meibomian gland dysfunction grade I, after treatment decreased to 14.5% (p <0.05), from 41, 6% to 25.3% (p <0.01) in grade II, and from 65.3% to 39.5% (p <0.001) in grade III.

The prescription of a new device-based treatment with Intensive Pulse Light is appropriate in cases where standard tear replacement therapy is ineffective in dry eye syndrome accompanied by varying degrees of meibomian gland dysfunction. In meibomian gland dysfunction grade III, treatment with the Lumenis M22 with Intensive Pulse Light module is the method of choice, the use of which can provide an increase in the stability of the tear film and the lipid layer thickening.