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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

Vegunta, Sravanthi BS; Patel, Dharmendra MD; Shen, Joanne F. MD

doi: 10.1097/ICO.0000000000000735
Clinical Science

Purpose: To assess the improvement in meibomian gland function and dry eye symptoms in patients with refractory dry eye treated with a combination therapy of intense pulsed light (IPL) and meibomian gland expression (MGX).

Methods: Medical records of 81 consecutive patients with dry eye treated with serial IPL/MGX were retrospectively examined to determine the outcome. All patients had a minimum of 6 months of follow-up after the first IPL/MGX treatment. Patients typically received 1 to 4 IPL treatments spaced 4 to 6 weeks apart. Each IPL session included MGX. Thirty-five charts had complete data for inclusion in analysis. We reviewed demographics, ocular histories, Standard Patient Evaluation of Eye Dryness 2 (SPEED2) symptom survey scores, slit-lamp examinations, and meibomian gland evaluations (MGE) at baseline and at each visit before IPL/MGX treatments.

Results: The paired t test showed a significant (P < 0.0001) decrease in SPEED2 with IPL/MGX therapy. Of the 35 patients, 8 (23%) had a ≥50% decrease in SPEED2, 23 (66%) had a 1% to 49% decrease in SPEED2, 1 (3%) had no change in SPEED2, and 3 (9%) had an increase in SPEED2. The Paired t test showed a significant increase in MGE in the left eye but not in the right eye (OD P = 0.163 and OS P = 0.0002). Thirteen patients (37%) had improved MGE bilaterally. Eight patients (23%) had either a decrease in MGE bilaterally or a decrease in 1 eye with no change in the other eye.

Conclusions: This retrospective analysis shows that the combination of IPL and MGX can significantly improve dry eye symptoms (in 89% of patients) and meibomian gland function (in 77% of patients in at least 1 eye).

*University of Arizona College of Medicine-Phoenix, Phoenix, AZ; and

Department of Ophthalmology, Mayo Clinic, Scottsdale, AZ.

Reprints: Joanne F. Shen, MD, Department of Ophthalmology, Mayo Clinic, 13400 E. Shea Boulevard, Scottsdale, AZ 85259 (e-mail:

Presented, in part, at the ARVO 2014 meeting, Orlando, FL, ARVO meeting abstract, May 4–8, 2014.

The authors have no funding or conflicts of interest to disclose.

Received May 23, 2015

Received in revised form November 07, 2015

Accepted November 10, 2015

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