Clinical outcomes and tear cytokine profiles of meibomian gland dysfunction treated with intense pulsed light

Abstract

Objective: To analyse the alteration in tear cytokine profiles, clinical outcome, and prognostic factors in meibomian gland dysfunction (MGD) patients treated with Intense Pulsed Light (IPL). Methods: Participants with moderate to severe MGD were treated with 3 sessions of IPL. Bimicroscopic examinations of meibomian glands and lid margins, tear break-up time (TBUT), ocular surface staining, interferometry, Ocular Surface Disease Index (OSDI), and tear cytokine levels were evaluated. Results: There was a significant improvement in clinical parameters including meibum quality, meibum expressibility, lid margin abnormality, TBUT, ocular surface staining, and OSDI. There was significant decrease in IL-6 and TNF-α. The decrease in tear cytokine levels were correlated with the improvement in clinical outcome (meibum quality, expressibility, lid margin abnormality, and ocular surface staining). Worse meibum expressibility, and low TBUT were associated with greater reduction in OSDI after treatment. Conclusions: IPL lead to decreased inflammation, improved meibomian gland function, and ocular surface stabilization in MGD patients. Improvement in meibomian expressibility was associated with the significant reduction of inflammatory cytokines, IL-6 and TNF-α, and baseline meibum nonexpressibility and low TBUT was associated with decreased subjective symptom score after treatment. Therefore, patients with obstructive MGD are especially likely to benefit from IPL treatment.