Clinical Factors Predicting Favorable Response to Intense Pulsed Light Therapy for Refractory Meibomian Gland Dysfunction: A 6-Month Cohort Study.

Purpose: Meibomian gland dysfunction (MGD) is a global health disorder, which can have a deleterious effect on visual function and quality of life. Intense pulsed light (IPL) therapy has been shown to ameliorate MGD. However, the optimal candidates who would benefit most from IPL remain undetermined. Therefore, we aimed in this study to identify the clinical factors associated with favorable outcomes in patients with MGD after IPL therapy.

Methods: This single-center retrospective study included patients with refractory MGD treated with a course of IPL therapy combined with meibomian gland expression, with a follow-up period of 6 months. The outcome measures were the standardized patient evaluation of eye dryness (SPEED) score, tear breakup time, lid telangiectasia, meibum quality, and expressibility. Good responders were defined as those with at least a 1-point reduction in SPEED score and a 1-grade decrease in meibum quality at 6 months. Data were analyzed using the t test, chi-square test, and binary logistic regression analysis.

Results: A total of 90 eyes in 90 patients (good responders: 48 eyes, nonresponders: 42 eyes) were included. Univariate analysis revealed that the good responders had a higher SPEED score at baseline than the nonresponders. Multivariate logistic regression analysis showed that more severe symptoms, more inspissated meibum, better expressibility, and milder degree of lid telangiectasia were independently associated with a favorable response.

Conclusions: Our findings suggest that patients with worse symptoms, poorer meibum quality, milder telangiectasia, or less obstruction are more likely to have a good response to IPL therapy.