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Abstract Objective: To observe the therapeutic effects of intense pulsed light (IPL) combined with meibomian
gland massage on dry eyes associated with meibomian gland dysfunction (MGD) using the meibomiangland analysis system. Methods: This study was a case series study. A total of 37 outpatients (74 eyes)
with MGD-related dry eyes were selected from July 2019 to August 2019 at Xi'an Fourth Hospital.
Patients underwent IPL treatment combined with meibomian gland massage (once every three weeks,
three times in all). Intergroup comparisons of the ocular surface disease index (OSDI), non-invasive tear
film rupture time (NITBUT), non-invasive lacrimal river height measurement (NITMH), meibomian gland
yielding secretion score (MGYSS), deformation coefficient and photographic value of the meibomian
gland analysis system were performed before treatment and after the first, second, and third treatments. A
repeated measurement analysis of variance (ANOVA) was used for evaluation. Pearson linear correlation
analysis was used to assess the relationships between the deformation coefficient and the photographic
value of the meibomian gland and other variables of ocular surface function. The therapeutic effects of
IPL combined with meibomian gland massage on dry eyes associated with MGD were further evaluated.
Results: Indexes, including OSDI, NITBUT, MGYSS and photographic value, at each time point after
treatment were significantly improved compared with those before treatment, and the difference was
statistically significant (P<0.001). There was no significant difference in the deformation coefficient after
the first and second treatments, while the deformation coefficient significantly decreased after the third
treatment (P=0.01). NITMH data showed no significant improvement at each time point after treatment
compared with before treatment, and the difference was not statistically significant. As the trends for the
indicators changed, OSDI, NITBUT, MGYSS and photographic values continued to improve after the first
treatment, and were best after the third treatment. In addition, the deformation coefficient changed gently,
with a significant improvement only after the third treatment. The results showed that the deformation
coefficient of the meibomian gland was positively correlated with OSDI (r=0.379, P=0.01), negatively
correlated with NITBUT (r=-0.427, P=0.01), and had no correlation with NITMH and MGYSS. The
photographic value of the meibomian gland had a significant negative correlation with OSDI (r=-0.904,
P<0.001), a positive correlation with NITBUT (r=0.947, P<0.001) and MGYSS (r=0.467, P<0.001), and
had no correlation with NITMH. In the study, there was no irreversible eyelid skin injury, no anterior
segment inflammatory reaction, iris depigmentation, ocular surface or fundus injury, decreased vision,
high intraocular pressure or other complications. Conclusions: Both intense pulsed light combined with
palpebral gland massage are convenient, safe and effective for MGD-related dry eyes. The meibomian
gland analysis system can monitor the secretion capacity of glands to a certain extent, which can be used
as a supplementary means to evaluate the therapeutic effect through specific quantitative data such as the
photographic value.
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