Diamond Bur Microblepharoexfoliation Combined with Intense Pulse Light and Meibomian Gland Expression for Evaporative Dry Eye: A Short-term Controlled Clinical Trial.

Introduction: To assess the efficacy and safety of the combination of microblepharoexfoliation (MBE), intense pulse light (IPL) and meibomian gland expression (MGX) for treatment of meibomian gland dysfunction (MGD). Methods: This was a prospective, parallel-control trial conducted from April 2022 t...

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Bibliographic Details
Authors: Ballesteros Sánchez, Antonio, Sánchez González, José María, Gutiérrez Ortega, Ramón, Gargallo Martínez, Beatriz
Format: article
Status:Published version
Publication Date:2024
Country:España
Institution:Universidad de Sevilla (US)
Repository:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/159619
Online Access:https://hdl.handle.net/11441/159619
https://doi.org/10.1007/s40123-024-00919-w
Access Level:Open access
Keyword:Microblepharoexfoliation
Intense pulse light
Meibomian gland expression
Meibomian gland dysfunction
Dry eye disease
Description
Summary:Introduction: To assess the efficacy and safety of the combination of microblepharoexfoliation (MBE), intense pulse light (IPL) and meibomian gland expression (MGX) for treatment of meibomian gland dysfunction (MGD). Methods: This was a prospective, parallel-control trial conducted from April 2022 to January 2023. Participants were assigned to receive either three sessions of MBE-IPL-MGX treatment and home-based therapy (treatment group) or home-based therapy alone (control group). Outcome measures were assessed at baseline and after 2-month follow-up. Results: Seventy eyes of 70 patients were enrolled. MBE-IPL-MGX treatment achieved better improvements than home-based therapy in ocular surface disease index (OSDI) and symptom assessment in dry eye (SANDE) scores, noninvasive tear film break-up time (NIBUT), lipid layer grade (LLG), loss area meibomian gland (LAMG) and meibomian gland yielding secretion score (MGYSS). The mean differences between the two groups were as follows: OSDI (– 11.23 ± 4.68 points, P \0.001), SANDE (– 24.63 ± 13.41 points, P \0.001), NIBUT (1.3 ± 1.57 s, P = 0.033), LLG (0.4 ± 0.04 points, P = 0.003), LAMG (– 2.85 ± 1.69%, P = 0.023) and MGYSS (7.5 ± 2.32 points, P \ 0.001). In addition, the increment (D) of MGYSS after MBE-IPL-MGX treatment was significantly higher in MGD grades 2 and 3 (all P \ 0.001). Conclusions: MBE-IPL-MGX treatment is an effective and well-tolerated procedure that improves dry eye symptoms and signs as well as meibomian gland secretions in patients with MGD. In addition, this treatment is recommended for MGD grades 2 and 3.