Combined Intense Pulsed Light and Low-Level Light Therapy for the Treatment of Dry Eye: A Retrospective Before–After Study with One-Year Follow-Up

Pérez-Silguero, M.A.; Pérez-Silguero, D.; Rivero‐Santana, Amado; Bernal-Blasco, Maria Inmaculada; Encinas-Pisa, Pablo

doi:10.2147/opth.s307020

Cited by 16 publications

(50 citation statements)

References 36 publications

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“…Similarly, a retrospective study by Pérez-Silguero et al 38 showed significant decrease of DED manifestations after four sessions of IPL+LLLT (0, 1, 4, and 12 weeks). As previously mentioned, the positive effects of IPL are observed after the first treatment session, peak between the last session and subsequent follow-up (usually 1–2 months after the last treatment session), and start to fade afterwards (in this series, at 6-month follow-up after baseline).…”

Section: Discussionmentioning

confidence: 71%

Pulsed Light Therapy in the Management of Dry Eye Disease: Current Perspectives

Ribeiro¹,

Marta²,

Ramalhão³

et al. 2022

OPTH

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To review the indications and efficacy of Intense Pulsed Light (IPL) application in the treatment of Meibomian Gland Dysfunction (MGD). Its main purpose is to describe its physiology, efficacy, indications, and adverse effects. Patients and Methods: A two database (PubMed, EMBASE) search was performed from July 2017 to July 2022 using the MeSH terms ("Intense Pulsed Light" AND ("Meibomian Gland Dysfunction" OR "Dry Eye"). We included randomized studies and systematic reviews with meta-analysis. Exclusion criteria were non-randomized trials, studies enrolling non-MGD dry eye disease, and other works older than 5 years. Results: Current literature shows that IPL is an effective and safe treatment modality for severe dry eye. Available evidence shows improvement of symptoms and objective indicators, such as noninvasive breakup time, thickness of lipid layer, and Schirmer test. However, our review concluded that the beneficial effects of IPL may lose some efficacy at 6-months after the initial session, and subsequent sessions may be required. Thus, IPL treatment should not be considered as first-line therapy for MGD but instead as an adjuvant option to the standard of care. The optimal treatment modality remains unknown and should be tailored according to each patient's phenotype, clinician's experience, and available technology. There is evidence that IPL treatment may down-regulate proinflammatory markers (such as interleukin (IL) 6, IL17a, IL-1) and Prostaglandin E2 (PGE2). Conclusion: MGD is a multifactorial disease and IPL treatment seems a promising treatment modality. Despite this, more evidence is needed to study its benefits -since this is an emerging technology, it is expected an increase in comparative studies in the following years, with longer follow-up periods, which may enable more precise conclusions about this treatment modality.

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Section: Discussionmentioning

confidence: 71%

Pulsed Light Therapy in the Management of Dry Eye Disease: Current Perspectives

Ribeiro¹,

Marta²,

Ramalhão³

et al. 2022

OPTH

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“…24 Regarding LLL, there is no published article exploring this treatment alone in humans. There are three previous single arm studies using IPL combined with LLL [12][13][14] , showing improvement in symptoms and objective measures, similar to the effect of IPL alone. However, proper comparisons with other studies using IPL alone were not possible given the variable methodologies used.…”

Section: Discussionmentioning

confidence: 79%

“…Other studies with longer follow-up periods observed an effect up to 3-6 months after similar treatment protocols. 8,12,14,19 It remains unclear if LLL will affect the results in the long term.…”

Section: Discussionmentioning

confidence: 99%

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The Benefit of Low-Level Light Therapy in Association with Intense Pulsed Light for Meibomian Gland Dysfunction

Marques

Marta

Baptista

et al. 2022

Preprint

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Purpose To study the clinical benefit of low-level light therapy when associated with intense pulsed light for the treatment of meibomian gland dysfunction. Methods An observational comparative study. Sixty-two (62) subjects were assigned 1:1 to one of two treatment arms: group 1 (31 subjects, 62 eyes), intense pulsed light followed by low-level light and group 2 (31 subjects, 62 eyes) intense pulsed light alone. In both groups, treatments were performed in 3 sessions and subjects were evaluated at baseline and 3 weeks after the last treatment session. Values are shown as Δ = mean difference ± standard deviation. Results We observed a significant improvement is OSDI-12 score and lipid layer thickness, in both groups (Δ=-22.7 ± 17.5, p < 0.001 in group 1 and Δ=-23.6 ± 23.8, p < 0.001 in group 2 for OSDI and Δ=+18.6 ± 37.0, p < 0.001 in group 1 and Δ=+19.9 ± 26.4, p < 0.001 in group 2 for lipid layer thickness). Despite no differences between groups at baseline (p = 0.469), only group 1 had a significant improvement in Schirmer test (Δ = + 1.6 ± 4.8, p = 0.009 in group 1 and Δ=+1.7 ± 6.9, p = 0.057 in group 2). No significant side effects were noted. No patient in any group felt subjectively “worse” after the treatment. Conclusion Intense pulsed light seems effective and safe for the treatment of meibomian gland dysfunction, improving symptoms and the tear film lipid layer. This study shows no strong evidence of the benefit of low-level light, but it shows weak evidence that it may further improve aqueous tear production.

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“…Other studies with longer follow-up periods observed an effect up to 3–6 months after similar treatment protocols. 8 , 12 , 14 , 19 It remains unclear if LLLT will affect the results in the long term.…”

Section: Discussionmentioning

confidence: 99%

Low-Level Light Therapy in Association with Intense Pulsed Light for Meibomian Gland Dysfunction

Marques¹,

Marta²,

Baptista³

et al. 2022

OPTH

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Purpose To study the clinical benefit of low-level light therapy when associated with intense pulsed light for the treatment of meibomian gland dysfunction. Methods An observational study. Two groups of patients that were treated with IPL were considered: group 1 (31 subjects, 62 eyes), intense pulsed light followed by low-level light therapy and group 2 (31 subjects, 62 eyes) intense pulsed light alone. In both groups, treatments were performed in 3 sessions and subjects were evaluated at baseline and 3 weeks after the last treatment session. Values are shown as mean difference ± standard deviation. Results We observed a significant improvement in OSDI-12 score and lipid layer thickness, in both groups (−22.7±17.5, p<0.001 in group 1 and −23.6±23.8, p<0.001 in group 2 for OSDI and +18.6 ± 37.0, p<0.001 in group 1 and +19.9 ± 26.4, p<0.001 in group 2 for lipid layer thickness). Despite no differences between groups at baseline (p=0.469), only group 1 had a significant improvement in Schirmer test (+1.6±4.8, p=0.009 in group 1 and +1.7±6.9, p=0.057 in group 2). No significant side effects were noted. No patient in any group felt subjectively “worse” after the treatment. Conclusion Intense pulsed light seems effective and safe for the treatment of meibomian gland dysfunction, improving symptoms and the tear film lipid layer. This study shows no strong evidence of the benefit of low-level light therapy, but it shows weak evidence that it may further improve aqueous tear production.

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Combined Intense Pulsed Light and Low-Level Light Therapy for the Treatment of Dry Eye: A Retrospective Before–After Study with One-Year Follow-Up

Cited by 16 publications

References 36 publications

Pulsed Light Therapy in the Management of Dry Eye Disease: Current Perspectives

Pulsed Light Therapy in the Management of Dry Eye Disease: Current Perspectives

The Benefit of Low-Level Light Therapy in Association with Intense Pulsed Light for Meibomian Gland Dysfunction

Low-Level Light Therapy in Association with Intense Pulsed Light for Meibomian Gland Dysfunction

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