Association of Meibomian Gland Orifice Changes with Intense Pulsed Light Treatment Response in Meibomian Gland...

To investigate epidemiological factors and clinical manifestations associated with longitudinal treatment response to intense pulsed light in patients with meibomian gland dysfunction (MGD).

This study was conducted on 392 eyes (392 patients) undergoing 4 sessions of IPL. Treatment response was evaluated using measurements of meibomian gland expressibility (MGE) and meibum quality (MQ). A generalized estimating equation (GEE) was applied to evaluate associations between epidemiological factors, clinical parameters, and longitudinal changes in MGE and MQ.

In adjusted GEE models, lower MGE and MQ grades indicated better meibomian gland function. Therefore, negative coefficients reflected improvement, whereas positive coefficients reflected a less favorable response. For MGE, worse baseline grade was associated with greater improvement after 4 sessions (B = -0.74, P < 0.001), although final MGE grades remained higher among eyes with higher baseline MGE grades. Telangiectasia across the meibomian gland orifice and keratinization were associated with less favorable MGE response (B = 0.52 and 0.30; P < 0.001 and 0.040, respectively). For MQ, worse baseline grade was associated with greater improvement (B = -0.85, P < 0.001), whereas telangiectasia across the orifice was associated with less favorable response (B = 1.45, P < 0.001).

After 4 sessions of IPL, worse baseline MGE and MQ grades were associated with greater longitudinal improvement. However, residual dysfunction remained, particularly for MGE among eyes with more severe baseline disease. Meibomian gland orifice changes, particularly telangiectasia across the orifice and keratinization, were associated with less favorable longitudinal response and may help inform prognostication and individualized treatment planning.