Comparison of two intense pulsed light patterns for treating patients with meibomian gland dysfunction

PURPOSE: The objective of this was to determine the efficacy of different patterns of intense pulsed light (IPL) therapy in patients with meibomian gland dysfunction (MGD). MATERIALS AND METHOD: IPL treatment was administered in 124 eyes of 62 patients with MGD-associated dry eye disease (DED). These patients were divided randomly into two groups treated with different IPL patterns. The first group was treated with "Optimal Pulse Technology" (OPT) (n = 29) and received three consecutive treatments (10-14 J/cm(2)) with three weeks between treatments. The other group was treated with "Intense Regulated Pulsed Light" (IRPL) (n = 33) and received four treatments (9-13 J/cm(2)) on days (D)1, D15, D45, and D75. The Ocular Surface Disease Index (OSDI), fluorescein breakup time (FTBUT), first and the average of noninvasive keratograph tear breakup times (NIKBUT), Schirmer I tests, conjunctival hyperemia, corneal fluorescent staining (CFS), tear meniscus height (TMH), MG secretion, and dropout were examined before each treatment and at one and three months after treatment. RESULTS: Compared to baseline, the clinical symptoms and signs in both groups were significantly improved at one and three months after IPL treatment. However, compared to the IRPL group, the OPT-treated group showed significant improvement in the clarity of MG secretions (P = 0.001), the number of MGs yielding clear or cloudy liquid secretions (P < 0.001), the total MG secretion score (P < 0.001) in lower eyelid, the lid margin score in upper (P < 0.001) and lower eyelids (P = 0.013), the first NIKBUT (P = 0.009), and FTBUT (P = 0.006). CONCLUSIONS: These results suggest that IPL has significant clinical value in treating patients with MGD. OPT IPL treatment was more effective in improving MG function in lower eyelids and partial tear film signs than IRPL IPL treatment. TRIAL REGISTRATION: The study was registered at www.clinicaltrials.gov, and the clinical trial accession number is NCT02481167.