Purpose

To evaluate the combined effect of intense pulsed light (IPL) therapy and meibomian gland expression on extracellular matrix metalloproteinase-9 (MMP-9) levels and clinical outcomes of moderate and severe meibomian gland dysfunction (MGD) treatment.

Methods

This retrospective study was conducted on 45 eyes of 23 patients with moderate and severe MGD. Each eye underwent three IPL sessions and meibomian gland expression at 2-week intervals. In this study the evaluated parameters included tear film break-up time (TBUT), corneal and conjunctival fluorescein staining scores, biomicroscopic examination of lid margins and meibomian glands, ocular surface disease index (OSDI) questionnaire score, and extracellular MMP-9 levels using the immunoassay device before and two weeks after the last treatment session. Linear mixed model and generalized estimating equations model were used to evaluate possible differences.

Results

There were significant improvements in TBUT (P < 0.001), SICCA ocular staining score (P = 0.008), Oxford staining score (P = 0.023), lid margin irregularity (P < 0.001 for upper and lower eyelids), lid thickness (P < 0.001 for upper and lower eyelids), meibomian gland plugging (P = 0.010 and P = 0.012 for upper and lower eyelids), meibum color (P = 0.044 and P < 0.001 for upper and lower eyelids), meibum consistency (P < 0.001 for upper and lower eyelids), MGD grade (P < 0.001), and OSDI questionnaire score (P < 0.001). Incidence of positive results for MMP-9 immunoassay significantly decreased from 84.0% to 56.0% (P = 0.031) after treatment.

Conclusion

In patients with moderate to severe MGD, three sessions of IPL combined with meibomian gland expression improved objective findings, subjective symptoms, meibomian gland function, and MMP-9 immunoassay results. The results support the combination of IPL and meibomian gland expression for treating moderate to severe MGD.

中文翻译：

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中重度睑板腺功能障碍患者强脉冲光联合睑板腺表达后基质金属蛋白酶9表达的变化

目的

评估强脉冲光 (IPL) 治疗和睑板腺表达对细胞外基质金属蛋白酶-9 (MMP-9) 水平和中重度睑板腺功能障碍 (MGD) 治疗的临床结果的综合影响。

方法

这项回顾性研究对 23 名中度和重度 MGD 患者的 45 只眼进行。每只眼睛每隔 2 周接受 3 次 IPL 治疗和睑板腺表达。在这项研究中，评估的参数包括泪膜破裂时间 (TBUT)、角膜和结膜荧光素染色评分、眼睑边缘和睑板腺的生物显微镜检查、眼表疾病指数 (OSDI) 问卷评分和细胞外 MMP-9 水平使用在最后一次治疗之前和两周之后的免疫测定装置。线性混合模型和广义估计方程模型用于评估可能的差异。

结果

TBUT（P < 0.001），SICCA眼部染色评分（P = 0.008），牛津染色评分（P = 0.023），眼睑边缘不规则（上下眼睑P < 0.001），眼睑厚度（P < 0.001）有显着改善上下眼睑为 0.001）、睑板腺堵塞（上下眼睑P = 0.010 和P = 0.012）、睑脂颜色（上下眼睑P = 0.044 和P < 0.001）、睑脂稠度（P < 0.001 为上下眼睑）、MGD 等级（P < 0.001）和 OSDI 问卷评分（P< 0.001)。治疗后 MMP-9 免疫测定阳性结果的发生率从 84.0% 显着降低至 56.0% ( P = 0.031)。

结论

在中重度 MGD 患者中，3 次 IPL 结合睑板腺表达改善了客观发现、主观症状、睑板腺功能和 MMP-9 免疫测定结果。结果支持结合 IPL 和睑板腺表达治疗中度至重度 MGD。