Network meta-analysis of different modalities of intense pulsed light therapy in the treatment of dry eye disease induced by meibomian gland dysfunction

Abstract

Purpose: This network meta-analysis aimed to evaluate the comparative effect of five different protocols of IPL treatment in treating MGD-related DED, including optimal pulse technology [OPT]-based IPL, E > eye-based IPL, OPT-based IPL plus meibomian gland expression (MGX), E > eye-based IPL plus MGX, Eyesis-based IPL plus MGX.

Methods: PubMed, Embase, Cochrane Library, SCOPUS and China National Knowledge Infrastructure (CNKI) were searched for eligible studies published before November 10, 2022.

Results: Random network meta-analysis was conducted to estimate the differences between different protocols of IPL treatment in ocular surface disease index (OSDI), standard patient evaluation of eye dryness (SPEED), tear break-up time (TBUT), meibomian gland quality (MGQ), meibomian gland evaluation (MGE), and corneal fluorescein staining (CFS). Rank probability showed OPT-based IPL plus MGX ranked first in OSDI and SPEED, E > eye-based IPL plus MGX ranked first in TUBT, MGQ, and CFS, but Eyesis-based IPL plus MGX ranked first in MGE.

Conclusions: Based on available evidence, for individuals with MGD-related DED, OPT-based IPL plus MGX may be the preferred treatment protocol for relieving ocular symptoms, but E > eye-based IPL plus MGX may be more beneficial for improving ocular function.

Keywords: Dry eye disease; Intense pulsed light; Meibomian gland dysfunction; Network meta-analysis.