Combining Low-level Light Therapy with IPL Most Effective for MGD

Eyes with MGD-associated dry eye disease responded well in this study to low-level light therapy alone or in combination with IPL. Both approaches showed significant improvements in symptom frequency and severity three months after treatment; however, only eyes receiving the combined therapy revealed reduced flavin fluorescence, suggesting that the addition of IPL helps boost cellular energy levels. Photo: Mila Ioussifova, OD. Click image to enlarge. Two emerging treatments for dry eye disease (DED) associated with meibomian gland dysfunction (MGD) are intense pulsed light therapy (IPL)—thought to lead to the breakdown of aberrant or telangiectatic blood vessels and decrease inflammation—and low-level light therapy (LLLT)—a more recent development intended to aid tissue repair and neural recovery. When performed alone, the latter procedure has been shown to alleviate clinical signs and symptoms better than IPL, prompting the authors of a new study to investigate whether LLLT is more effective for MGD-related DED on its own or in combination with IPL. Their findings, published on Monday in Contact Lens and Anterior Eye, revealed that while both approaches improved symptom frequency and severity, combined therapy held an advantage in boosting cellular energy levels.This study was conducted as a single-centre, double-masked, randomized, paired-eye clinical trial, including 24 participants diagnosed with MGD and DED. One eye of each participant was randomly selected to receive either the combined therapy or LLLT alone, while the other eye received the alternate treatment. The researchers assessed ocular surface changes during, two weeks after and three months after the four treatment sessions, spaced two to three weeks apart.The results revealed significant improvements in symptomatology across both treatment modalities. Notably, the mean change in Symptom Assessment Questionnaire for Dry Eye (SANDE) frequency improved from baseline to final follow-up, with the combined therapy group showing a change of -21.6, while the LLLT alone group demonstrated a change of -20.5. The symptom severity rating on the SANDE scale significantly improved for the combined therapy, recording a mean difference of -18.5.Furthermore, meibum expressibility saw improvements in both groups after treatment, with a mean difference of -0.5 reported following the third treatment session. Importantly, the study did not report any adverse effects throughout its duration, a testament to the safety and tolerability of both treatment modalities.Advanced diagnostics indicated variations in tissue metabolism, with reduced flavin fluorescence observed only in the combined therapy group, suggesting beneficial effects on cellular metabolism. ”This implies that the combined therapy with IPL is more effective at boosting cellular energy levels, which may be crucial for tissue repair and regeneration,” the researchers explained in their paper on the study. While this suggests superiority of the combined therapy approach, the researchers note that “LLLT alone could be considered in clinical settings as an adjunctive therapy for MGD if IPL is contraindicated for improving meibum expressibility and symptom frequency.”This study has several limitations, including its small sample size and paired eye design, which may have subjected the data to crossover effects from one eye to the other during treatment. Especially since LLLT is so new, future studies investigating its efficacy when used alone are warranted to better understand how it can optimize current dry eye regimens, the authors concluded.Click here for the journal source. Chiang JCB, Zhang AC, Ahmadzai V, et al. Low-level light therapy versus intense pulsed light for the treatment of meibomian gland dysfunction: Preliminary results from a prospective randomized comparative study. Cont Lens Anterior Eye. June 9, 2025. [Epub ahead of print].