RESUMEN
AIM: To systematically evaluate the efficacy of intense pulsed light(IPL)combined with meibomian gland expression(MGX)in the treatment of meibomian gland dysfunction(MGD)-related dry eye disease(DED).METHODS: Chinese and English databases such as Chinese national knowledge infrastructure(CNKI), Wanfang, VIP, CBM, ClinicalTrials, PubMed, Embase and Web of Science were searched, and clinical randomized controlled trials(RCTs)using IPL combined with MGX in the experimental group and MGX alone in the control group from January 2017 to September 2022 were included. Six outcome indicators including clinical efficacy, ocular surface disease index(OSDI)score, break-up time(BUT), corneal fluorescein staining(CFS)score, tear meniscus height(TMH)and meibomian gland yielding secretion score(MGYSS)were Meta analyzed by Review Manager 5.3 and Stata 14 software.RESULTS: A total of 15 RCTs were included, with 1 345 patients with MGD-related dry eye. Meta-analysis results showed that the treatment of MGD-related dry eye in the experimental group improved better clinical efficacy(OR=4.95, 95%CI: 2.76～8.90, Z=5.35, P<0.00001), BUT(SMD=1.26, 95%CI: 0.84～1.69, Z=5.78, P<0.00001), TMH(SMD=0.37, 95%CI: 0.15～0.59, Z=3.33, P=0.0009), and reduced OSDI scores(SMD=-0.86, 95%CI: -1.44～-0.27, Z=2.85, P=0.004)as well as MGYSS(SMD=-2.43, 95%CI: -4.31～-0.54, Z=2.52, P=0.01)than the control group. However, there was no statistically significant difference in CFS scores(SMD=-0.19, 95%CI: -0.46～0.07, Z=1.43, P=0.15).CONCLUSION: IPL combined with MGX in the treatment of MGD related dry eye can increase the overall effective rate and improve the symptoms and signs of patients with MGD related dry eye better than MGX alone.
RESUMEN
@#AIM: To compare short-term effectiveness of E-eye IPL combined with meibomian gland expression to simple meibomian gland expression in the treatment of meibomian gland dysfunction(MGD).<p>METHODS: Totally 40 patients with MGD(80 eyes)visiting the Department of Ophthalmology of West China Hospital of Sichuan University from October 2019 to January 2020 were randomly divided into experimental group and control group. Both eyes in the experimental group received IPL combined with meibomian gland expression, while those in the control group received meibomian gland expression only once every 2wk for 3 times. During the whole treatment, patients in the two groups received 0.3% sodium hyaluronate 4 times a day. Metrics were collected before each treatment and 2wk after the last treatment to evaluate the short-term efficacy of IPL combined with meibomian gland expression.<p>RESULTS: OSDI and SPEED scores of the two groups decreased with statistical significance(<i>P</i><0.05), but there was no statistical significance between the two groups(<i>P</i>>0.05). MGE and LLT of both groups increased. The increase in the control group was slower than that in the experimental group. MGE of the experimental group was higher than that of the control group after the second and third treatment, with statistical significance(<i>P</i><0.05). BUT of both groups increased. Corneal staining in both groups decreased, and it decreased more in the experimental group than in the control group, with no statistical significance between the two groups(<i>P</i>>0.05). The visual quality in the two groups improved, but in improving visual quality the experimental group was much better than the control group(<i>P</i>>0.05). There was no significant change in tear secretion, incomplete blink ratio and meibomian gland loss rate in the two groups(<i>P</i>>0.05). There were no skin and visual impairment, intraocular pressure change, anterior segment inflammation and other complications in all subjects.<p>CONCLUSION:IPL combined with meibomian gland expression and meibomian gland expression alone are both safe and effective. IPL, which has good, rapid effects and cumulative effects, works better after reaching a certain number of treatments.