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To make appropriate therapeutic decisions of intense pulsed light (IPL) for meibomian gland dysfunction (MGD) patients. Sixty patients with MGD stage 2–3 were enrolled in IPL Group1 and Self-hygiene Group; 110 patients with MGD stage 3–4 were included in IPL + MGX Group and IPL Group2. Patients in IPL groups received IPL treatment once a month for three times. Meibomian gland expression (MGX) was combined with IPL treatment in IPL + MGX Group. Meibomian gland (MG) functions, MGD stage, associated ocular-surface indexes, and response rate were evaluated. Population characteristics and clinical conditions were comparable between groups. In patients with MGD stage 2–3, both IPL Group1 and Self-hygiene Group improved in MG functions, ocular surface disease index (OSDI) and tear break-up time (TBUT). No statistical difference was found in improvements. Posttreatment response rate was 64.3–66.7% in two groups. In patients with MGD stage 3–4, IPL + MGX Group achieved better improvements in MG expressibility and higher response rate (75.5%) than IPL Group2 (63.3%). Referring to IPL treatment, no statistical difference in MG functions and OSDI improvements was found among MGD patients with different ages, genders, and IPL energy exposure. Patients with higher Fitzpatrick scale improved more in MG expressibility. Self-eyelid hygiene is cost-effective for milder MGD stages. Combining MGX with IPL is necessary in more severe stages. Adult patients with all age and different genders can benefit from IPL treatment. Patients with darker skin can benefit more in expressiblity. [ABSTRACT FROM AUTHOR]

Purpose: To observe (1) changes in meibomian gland (MG) after exposure to intense pulsed light (IPL) and (2) to understand the mechanism by which IPL treats meibomian gland dysfunction (MGD) in patients. Methods: A cohort study, including 35 MGD patients, was conducted. IPL treatment was administered in one group (IPL group;n = 18), and eyelid hygiene in another (control group;n = 17) for 3 months. All patients were given artificial tears during the treatment period. Associated ocular-surface indexes (ocular surface disease index, OSDI; tear breakup time, TBUT, Schirmer 1Test, corneal staining, and conjunctival staining), MG function, MG macro-morphology, and MG micro-morphology were examined before and after treatment. The relationships between the change in symptom score and the change in the other indexes (related ocular-surface indexes, MG functional indexes, and MG morphological indexes) were evaluated. Results: There was no statistical difference in pretreatment between the IPL and the control groups in terms of age, gender, related medical history, MGD stage, and all examined indexes, with the exception of conjunctival staining. OSDI, TBUT, meibum quality, MG expressibility, and MG dropout improved after treatment in both of the two groups (allP < 0.05). The MG microstructure indexes, including the MG acinar longest diameter (ALD), MG acinar unit density (AUD), and the positive rate of inflammatory cells (ICs) around glandular structures were significantly improved in the IPL group. No improvements of microstructure were found in the control group. Conclusion: IPL treatment improves the symptom score of patients, associated ocular-surface indexes, MG function, and MG macrostructure as well as eyelid hygiene. And IPL treatment particularly improves MG microstructure and decreases MG inflammation in MGD patients. [ABSTRACT FROM PUBLISHER]