Focal Subthreshold Laser Photocoagulation of Eyelid Margin Vascularity in Telangiectatic Meibomian Gland Dysfunction.

PURPOSE: To evaluate the safety and efficacy of subthreshold micropulse laser photocoagulation for dry eye disease (DED) associated with telangiectatic meibomian gland dysfunction (MGD).

METHODS

In this prospective contralateral eye study, 60 eyes from 30 patients with DED secondary to MGD were randomized to receive either a single session of focal 532-nm subthreshold laser photocoagulation of eyelid margin telangiectasias (Laser Group, LG) or a sham treatment (Control Group, CG). Evaluations were performed at baseline and 2, 4, 8, and 12 weeks posttreatment and included Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), Schirmer test, tear meniscus height and depth, eyelid margin vascularity, meibomian gland expressivity and secretion quality, ocular surface staining, meiboscore, and assessment of eyelid margin abnormalities. Best-corrected visual acuity (BCVA) and adverse events were recorded.

RESULTS

LG showed early and sustained improvements in tear film stability, tear meniscus parameters, and corneal staining from week 2 to week 12 (P < 0.05). No significant changes were observed in CG. Eyelid margin vascularity was significantly reduced until week 8 in LG (P < 0.001), with improvements in meibomian gland expressivity and secretion quality. Meiboscore and chronic eyelid margin structural features remained unchanged in both groups (P > 0.05). No ocular or systemic adverse events occurred, and BCVA remained stable throughout the follow-up period.

CONCLUSIONS

Focal subthreshold micropulse laser photocoagulation of eyelid margin telangiectasias appears to be a safe and effective adjunctive treatment for DED associated with MGD.