"Stepwise Extension Treatment Protocol" versus "Pro Re Nata Regimen" of Intense Pulsed Light for Meibomian Gland...

Area of Science:

• Ophthalmology
• Medical Treatments

Background:

• Meibomian gland dysfunction (MGD) is a common condition affecting the ocular surface.
• Intense pulsed light (IPL) therapy is a recognized treatment for MGD.

Purpose of the Study:

• To compare the efficacy of stepwise extension treatment (SET) versus a pro re nata (PRN) regimen of IPL with warm compresses for MGD.
• To evaluate long-term outcomes and treatment frequency over 24 months.

Main Methods:

• Prospective comparative study involving 412 participants with MGD.
• Initial 4 IPL sessions at 4-week intervals, followed by individualized interval adjustments (SET) or PRN re-treatment based on clinical criteria.
• Primary outcomes included changes in Ocular Surface Disease Index (OSDI), meibomian gland expressibility (MGE), and meibum quality (MQ).

Main Results:

• Both SET and PRN regimens showed significant improvements in OSDI, MGE, and MQ (P > 0.05).
• Patients with mild-to-moderate MGD (MGE/MQ grade ≤2) responded well to both protocols.
• The SET group demonstrated greater improvement in severe MGD (MGE grade 3) (P < 0.01) with fewer exacerbations compared to the PRN group.
• The SET group required more IPL sessions (mean 14.8) than the PRN group (mean 10.0) over 24 months (P < 0.01).

Conclusions:

• Both SET and PRN regimens are effective for symptomatic and functional improvement in MGD.
• Individualized treatment approaches are crucial, with SET potentially offering superior long-term control in severe MGD cases.