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Published in: BMC Ophthalmology 1/2022

Open Access 01-12-2022 | Intense Pulsed Light | Research

Outcomes of serial sessions of Activa mask combined with intense pulsed light therapy in patients with Meibomian gland dysfunction

Authors: Luca Vigo, Marco Pellegrini, Francesco Carones, Vincenzo Scorcia, Giuseppe Giannaccare

Published in: BMC Ophthalmology | Issue 1/2022

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Abstract

Background

To evaluate the effects on ocular surface signs and symptoms of serial sessions of heating and vibrating eye mask followed by intense pulsed light (IPL) therapy for the treatment of dry eye disease owing to meibomian gland dysfunction (MGD).

Methods

Consecutive patients with MGD whose signs and symptoms were not satisfactorily controlled with conventional therapy were included. Patients received 3 treatments performed at day 1, 15, and 45 incorporating a session with a newly-developed eye mask (Activa, SBS Sistemi, Turin, Italy) immediately followed by IPL therapy (E > Eye device, E-Swin, Paris, France). Patients were examined before the first session (T0) and 30 days after the last session (T1) for the measurement of: noninvasive break-up time (NIBUT); lipid layer thickness (LLT); tear meniscus height (TMH); meibomian gland loss (MGL); tear osmolarity. Ocular discomfort symptoms were ascertained by ocular surface disease index (OSDI) questionnaire.

Results

Thirty patients were ultimately included in the study. At T1, all objective ocular surface parameters improved significantly, except for TMH: NIBUT and LLT increased from 6.4 ± 1.7 to 8.6 ± 1.7 s and from 57.7 ± 15.5 to 81.3 ± 12.0 μm (all P < 0.001), while MGL and tear osmolarity decreased from 21.1 ± 17.3 to 17.0 ± 14.1% and from 302.0 ± 8.5 to 295.7 ± 6.9 mOsm/L (respectively, P = 0.004 and P < 0.001). In parallel, OSDI score decreased significantly from 49.8 ± 13.5 to 29.8 ± 10.6 (P < 0.001). In the historical control group of patients who underwent only IPL, NIBUT, LLT, tear osmolarity and OSDI improved significantly but not MGL and TMH.

Conclusions

Serial sessions incorporating the application of an eye mask producing heating and vibration immediately followed by IPL therapy are able to improve all ocular surface parameters as well as ocular discomfort symptoms in MGD patients.
Literature
1.
go back to reference Giannaccare G, Vigo L, Pellegrini M, et al. Ocular surface workup with automated noninvasive measurements for the diagnosis of Meibomian gland dysfunction. Cornea. 2018;37:740–5.CrossRef Giannaccare G, Vigo L, Pellegrini M, et al. Ocular surface workup with automated noninvasive measurements for the diagnosis of Meibomian gland dysfunction. Cornea. 2018;37:740–5.CrossRef
2.
go back to reference Knop E, Knop N, Millar T, et. al. The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. Invest Ophthalmol Vis Sci 2011;52:1938–1978. Knop E, Knop N, Millar T, et. al. The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. Invest Ophthalmol Vis Sci 2011;52:1938–1978.
3.
go back to reference Nichols KK, Foulks GN, Bron AJ, et al. The international workshop on meibomian gland dysfunction: executive summary. Invest Ophthalmol Vis Sci. 2011;52:1922–9.CrossRef Nichols KK, Foulks GN, Bron AJ, et al. The international workshop on meibomian gland dysfunction: executive summary. Invest Ophthalmol Vis Sci. 2011;52:1922–9.CrossRef
4.
go back to reference Rabensteiner DF, Aminfar H, Boldin I, et. al. The prevalence of meibomian gland dysfunction, tear film and ocular surface parameters in an Austrian dry eye clinic population. Acta Ophthalmol 2018;96:e707-e711. Rabensteiner DF, Aminfar H, Boldin I, et. al. The prevalence of meibomian gland dysfunction, tear film and ocular surface parameters in an Austrian dry eye clinic population. Acta Ophthalmol 2018;96:e707-e711.
5.
go back to reference Sabeti S, Kheirkhah A, Yin J, et al. Management of meibomian gland dysfunction: a review. Surv Ophthalmol. 2020;65:205–17.CrossRef Sabeti S, Kheirkhah A, Yin J, et al. Management of meibomian gland dysfunction: a review. Surv Ophthalmol. 2020;65:205–17.CrossRef
6.
go back to reference Giannaccare G, Pellegrini M, Sebastiani S, et al. Efficacy of omega-3 fatty acid supplementation for treatment of dry eye disease: a meta-analysis of randomized clinical trials. Cornea. 2019;38:565–73.CrossRef Giannaccare G, Pellegrini M, Sebastiani S, et al. Efficacy of omega-3 fatty acid supplementation for treatment of dry eye disease: a meta-analysis of randomized clinical trials. Cornea. 2019;38:565–73.CrossRef
7.
go back to reference Greiner JV. A single LipiFlow® thermal pulsation system treatment improves meibomian gland function and reduces dry eye symptoms for 9 months. Curr Eye Res. 2012;37:272–8.CrossRef Greiner JV. A single LipiFlow® thermal pulsation system treatment improves meibomian gland function and reduces dry eye symptoms for 9 months. Curr Eye Res. 2012;37:272–8.CrossRef
8.
go back to reference Arita R, Fukuoka S. Non-pharmaceutical treatment options for meibomian gland dysfunction. Clin Exp Optom. 2020;103:742–55.CrossRef Arita R, Fukuoka S. Non-pharmaceutical treatment options for meibomian gland dysfunction. Clin Exp Optom. 2020;103:742–55.CrossRef
10.
go back to reference Li D, Lin SB, Cheng B. Intense pulsed light: from the past to the future. Photomed Laser Surg. 2016;34:435–47.CrossRef Li D, Lin SB, Cheng B. Intense pulsed light: from the past to the future. Photomed Laser Surg. 2016;34:435–47.CrossRef
11.
go back to reference Dell SJ. Intense pulsed light for evaporative dry eye disease. Clin Ophthalmol. 2017;11:1167–73.CrossRef Dell SJ. Intense pulsed light for evaporative dry eye disease. Clin Ophthalmol. 2017;11:1167–73.CrossRef
12.
go back to reference Liu R, Rong B, Tu P, et al. Analysis of cytokine levels in tears and clinical correlations after intense pulsed light treating meibomian gland dysfunction. Am J Ophthalmol. 2017;183:81–90.CrossRef Liu R, Rong B, Tu P, et al. Analysis of cytokine levels in tears and clinical correlations after intense pulsed light treating meibomian gland dysfunction. Am J Ophthalmol. 2017;183:81–90.CrossRef
13.
go back to reference Giannaccare G, Taroni L, Senni C, et al. Intense pulsed light therapy in the treatment of Meibomian gland dysfunction: current perspectives. Clin Optom (Auckl). 2019;11:113–26.CrossRef Giannaccare G, Taroni L, Senni C, et al. Intense pulsed light therapy in the treatment of Meibomian gland dysfunction: current perspectives. Clin Optom (Auckl). 2019;11:113–26.CrossRef
14.
go back to reference Toyos R, McGill W, Briscoe D. Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retrospective study. Photomed Laser Surg. 2015;33:41–6.CrossRef Toyos R, McGill W, Briscoe D. Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retrospective study. Photomed Laser Surg. 2015;33:41–6.CrossRef
15.
go back to reference Gupta PK, Vora GK, Matossian C, et al. Outcomes of intense pulsed light therapy for treatment of evaporative dry eye disease. Can J Ophthalmol. 2016;51:249–53.CrossRef Gupta PK, Vora GK, Matossian C, et al. Outcomes of intense pulsed light therapy for treatment of evaporative dry eye disease. Can J Ophthalmol. 2016;51:249–53.CrossRef
16.
go back to reference Vegunta S, Patel D, Shen JF. Combination therapy of intense pulsed light therapy and meibomian gland expression (IPL/MGX) can improve dry eye symptoms and meibomian gland function in patients with refractory dry eye: a retrospective analysis. Cornea. 2016;35:318–22.CrossRef Vegunta S, Patel D, Shen JF. Combination therapy of intense pulsed light therapy and meibomian gland expression (IPL/MGX) can improve dry eye symptoms and meibomian gland function in patients with refractory dry eye: a retrospective analysis. Cornea. 2016;35:318–22.CrossRef
17.
go back to reference Jiang X, Lv H, Song H, et al. Evaluation of the safety and effectiveness of intense pulsed light in the treatment of meibomian gland dysfunction. J Ophthalmol. 2016;2016:1910694.PubMedPubMedCentral Jiang X, Lv H, Song H, et al. Evaluation of the safety and effectiveness of intense pulsed light in the treatment of meibomian gland dysfunction. J Ophthalmol. 2016;2016:1910694.PubMedPubMedCentral
18.
go back to reference Albietz JM, Schmid KL. Intense pulsed light treatment and meibomian gland expression for moderate to advanced meibomian gland dysfunction. Clin Exp Optom. 2018;101:23–33.CrossRef Albietz JM, Schmid KL. Intense pulsed light treatment and meibomian gland expression for moderate to advanced meibomian gland dysfunction. Clin Exp Optom. 2018;101:23–33.CrossRef
19.
go back to reference Arita R, Mizoguchi T, Fukuoka S, et al. Multicenter study of intense pulsed light therapy for patients with refractory meibomian gland dysfunction. Cornea. 2018;37:1566–71.CrossRef Arita R, Mizoguchi T, Fukuoka S, et al. Multicenter study of intense pulsed light therapy for patients with refractory meibomian gland dysfunction. Cornea. 2018;37:1566–71.CrossRef
20.
go back to reference Mejía LF, Gil JC, Jaramillo M. Intense pulsed light therapy: a promising complementary treatment for dry eye disease. Arch Soc Esp Oftalmol. 2019;94:331–6.CrossRef Mejía LF, Gil JC, Jaramillo M. Intense pulsed light therapy: a promising complementary treatment for dry eye disease. Arch Soc Esp Oftalmol. 2019;94:331–6.CrossRef
21.
go back to reference Choi M, Han SJ, Ji YW, et al. Meibum Expressibility improvement as a therapeutic target of intense pulsed light treatment in meibomian gland dysfunction and its association with tear inflammatory cytokines. Sci Rep. 2019;9:1–8.CrossRef Choi M, Han SJ, Ji YW, et al. Meibum Expressibility improvement as a therapeutic target of intense pulsed light treatment in meibomian gland dysfunction and its association with tear inflammatory cytokines. Sci Rep. 2019;9:1–8.CrossRef
23.
go back to reference Ahmed SA, Taher IME, Ghoneim DF, et al. Effect of intense pulsed light therapy on tear proteins and lipids in meibomian gland dysfunction. J Ophthalmic Vis Res. 2019;14:3–10.CrossRef Ahmed SA, Taher IME, Ghoneim DF, et al. Effect of intense pulsed light therapy on tear proteins and lipids in meibomian gland dysfunction. J Ophthalmic Vis Res. 2019;14:3–10.CrossRef
24.
go back to reference Vigo L, Taroni L, Bernabei F, et al. Ocular surface workup in patients with Meibomian gland dysfunction treated with intense regulated pulsed light. Diagnostics (Basel). 2019;9:147.CrossRef Vigo L, Taroni L, Bernabei F, et al. Ocular surface workup in patients with Meibomian gland dysfunction treated with intense regulated pulsed light. Diagnostics (Basel). 2019;9:147.CrossRef
25.
go back to reference Craig JP, Chen YH, Turnbull PRK. Prospective trial of intense pulsed light for the treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci. 2015;56:1965–70.CrossRef Craig JP, Chen YH, Turnbull PRK. Prospective trial of intense pulsed light for the treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci. 2015;56:1965–70.CrossRef
26.
go back to reference Yan X, Hong J, Jin X, et al. The efficacy of intense pulsed light combined with Meibomian gland expression for the treatment of dry eye disease due to Meibomian gland dysfunction: a multicenter. Randomized Controlled Trial Eye Contact Lens. 2021;47:45–53.CrossRef Yan X, Hong J, Jin X, et al. The efficacy of intense pulsed light combined with Meibomian gland expression for the treatment of dry eye disease due to Meibomian gland dysfunction: a multicenter. Randomized Controlled Trial Eye Contact Lens. 2021;47:45–53.CrossRef
27.
go back to reference Valencia-Nieto L, Novo-Diez A, Blanco-Vazquez M, et al. Therapeutic instruments targeting meibomian gland dysfunction. Ophthalmol Ther. 2020;9:797–807.CrossRef Valencia-Nieto L, Novo-Diez A, Blanco-Vazquez M, et al. Therapeutic instruments targeting meibomian gland dysfunction. Ophthalmol Ther. 2020;9:797–807.CrossRef
28.
go back to reference Cote S, Zhang AC, Ahmadzai V, et al. Intense pulsed light (IPL) therapy for the treatment of meibomian gland dysfunction. Cochrane Database Syst Rev. 2020;3:CD013559.PubMed Cote S, Zhang AC, Ahmadzai V, et al. Intense pulsed light (IPL) therapy for the treatment of meibomian gland dysfunction. Cochrane Database Syst Rev. 2020;3:CD013559.PubMed
29.
go back to reference Huang X, Qin Q, Wang L, et al. Clinical results of Intraductal Meibomian gland probing combined with intense pulsed light in treating patients with refractory obstructive Meibomian gland dysfunction: a randomized controlled trial. BMC Ophthalmol. 2019;19:211.CrossRef Huang X, Qin Q, Wang L, et al. Clinical results of Intraductal Meibomian gland probing combined with intense pulsed light in treating patients with refractory obstructive Meibomian gland dysfunction: a randomized controlled trial. BMC Ophthalmol. 2019;19:211.CrossRef
30.
go back to reference Stonecipher K, Abell TG, Chotiner B, et al. Combined low level light therapy and intense pulsed light therapy for the treatment of meibomian gland dysfunction. Clin Ophthalmol. 2019;13:993–9.CrossRef Stonecipher K, Abell TG, Chotiner B, et al. Combined low level light therapy and intense pulsed light therapy for the treatment of meibomian gland dysfunction. Clin Ophthalmol. 2019;13:993–9.CrossRef
31.
go back to reference Giannaccare G, Pellegrini M, Carnovale Scalzo G, et al. Low level therapy versus intense pulsed light for the treatment of Meibomian gland dysfunction: preliminary results from a prospective randomized comparative study. Cornea. 2021. https://doi.org/10.1155/2021/1370001. Giannaccare G, Pellegrini M, Carnovale Scalzo G, et al. Low level therapy versus intense pulsed light for the treatment of Meibomian gland dysfunction: preliminary results from a prospective randomized comparative study. Cornea. 2021. https://​doi.​org/​10.​1155/​2021/​1370001.
Metadata
Title
Outcomes of serial sessions of Activa mask combined with intense pulsed light therapy in patients with Meibomian gland dysfunction
Authors
Luca Vigo
Marco Pellegrini
Francesco Carones
Vincenzo Scorcia
Giuseppe Giannaccare
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2022
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-022-02538-0

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