While Glaucoma Meds Limit IPL Outcomes, Researchers Still Highlight Benefits

This comparative study demonstrated the one-year outcomes of IPL with meibomian gland expression treatment in MGD patients with and without chronic hypotensive eye drops. Photo: Hardeep Kataria, OD. Click image to enlarge. Ocular symptoms resulting from meibomian gland dysfunction (MGD) significantly impair quality of life and reduce medication adherence for patients on chronic topical therapy, even diminishing the effectiveness of antiglaucoma treatments. As a result, exploring effective and sustainable treatments for glaucoma patients with MGD is critical. In light of the potential for glaucoma medication exposure to diminish the long-lasting effects of intense pulsed light (IPL), researchers in Taiwan believed that there was a pressing need to conduct a study that observed the effects of IPL over a more extended follow-up period. Doing so would help validate IPL’s clinical utility for glaucoma patients who rely on long-term topical hypotensive medications to manage their intraocular pressure (IOP).Their recent study, which was published in Eye, noted that patients with MGD plus glaucoma and those with MGD but no glaucoma showed significant improvement in Standard Patient Evaluation of Eye Dryness Questionnaire (SPEED) score and tear break-up time (TBUT) at nine months, but only the non-glaucoma group maintained these improvements at 12 months. While meibum quality improved in both groups at 12 months, significant improvement in lid telangiectasia and meibum expressibility was observed only in the non-glaucoma group. Still, the group highlighted that the regular performance of meibomian gland expression following IPL may contribute to the continual improvement of meibomian gland function.“Our study reveals the enduring impact of IPL therapy on both groups, notably in terms of the meibum quality, which showed improvement throughout one year,” the researchers wrote in their paper. “However, the beneficial effects of IPL in amelioration of SPEED and TBUT were less sustained in glaucoma patients than in non-glaucoma patients.”This retrospective study included 21 MGD eyes of 21 glaucoma patients (age: 64.38 years) and 21 MGD eyes of 21 non-glaucoma patients (age: 63.90 years). Both groups received IPL therapy with meibomian gland expression. SPEED questionnaire, TBUT, lid telangiectasia, corneal staining, meibum quality and expressibility were assessed at baseline, as well as, three-, six-, nine- and 12-months post-treatment.The researchers suggested that reason that the beneficial effect of IPL on lid telangiectasia of glaucoma patients was not observed at 12 months post-treatment was likely due to the long-term and concurrent use of hypotensive eye drops, which has been linked to ocular surface inflammation and eyelid margin abnormalities. The drops might counteract the anti-inflammatory effect of IPL therapy.The study authors suggest that IPL combined with regular meibomian gland expression “could be a promising treatment option for patients with MGD,” they concluded. “This includes patients with glaucoma who are chronically medicated and more vulnerable to developing MGD-related ocular surface diseases.”Click here for the journal source. Yang CC, Ko YC, Hwang DK, et al. One-year outcome of intense pulsed light therapy for refractory meibomian gland dysfunction in patients continuously exposed to topical glaucoma medications: a comparative study. Eye (Lond). July 2, 2025. [Epub ahead of print].