The combination of meibomian gland probing and intense pulsed light in the treatment of refractory blepharitis

Introduction. Refractory blepharitis is a complex disease of the anterior segment of the eye, characterized by prolonged course and persistent symptoms that significantly reduce patients’ quality of life. Conventional treatment methods, including eyelid hygiene, warm compresses, and topical antibiotic therapy, are often insufficiently effective. In recent years, researchers have focused on novel approaches such as probing of meibomian glands (MGP) and the use of intense pulsed light (IPL), as well as their combination.

Aim. To evaluate the efficacy of treating refractory bilateral blepharitis using a combination of meibomian gland probing (MGP) and intense pulsed light (IPL) therapy.

Materials and methods. A total of 200 patients (400 eyes) with a diagnosis of refractory bilateral blepharitis were included in this prospective comparative study and randomized into four groups: combined therapy (MGP + IPL), MGP alone, IPL alone, and a control group. Treatment efficacy was assessed using the SPEED (standard patient evaluation of eye dryness) questionnaire, meibography, non-invasive tear break-up time (NIBUT), meibomian gland expression test, and the Oxford scale for ocular surface staining.

Results and discussion. The most pronounced therapeutic effect was observed in the combined treatment group (MGP + IPL), with significant improvement evident as early as one month after treatment: reduction in symptoms according to the SPEED score, increased NIBUT and tear meniscus height, and decreased meibomian gland atrophy. This positive effect persisted over a 6-month follow-up period. The combination of these two modalities provides a synergistic effect: mechanical restoration of meibomian gland duct patency through probing, together with the anti-inflammatory action of IPL, contributes to stabilization of the tear film and slows the progression of the pathological process.

Conclusion. The combined use of MGP and IPL demonstrates high efficacy in the treatment of refractory blepharitis and surpasses monotherapy. The obtained results confirm the promise of this approach and highlight the need for further research to optimize clinical guidelines.

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