Intense regulated pulse light for the meibomian gland dysfunction

Abstract

Purpose: To assess the effect of intense regulated pulse light (E-Eye; E-Swin, France) on the treatment of meibomian gland dysfunction. Setting: Health Sciences University, Ankara Numune Training and Research Hospital, Department of Ophthalmology. Methods: A total of 26 patients underwent intense pulsed light treatment (E-Eye; E-Swin), with homogeneously sequenced five light pulses delivered to one eye at 1, 15, and 45 days following baseline evaluation. At each visit, subjective clinical parameters (ocular surface disease index questionnaire and standard patient evaluation of eye dryness questionnaire) and objective clinical parameters (Schirmer I test scores, tear break-up times, Oxford grading, lid margin abnormality score, secretion quality and expressibility degree) were recorded. The subjective and objective parameters at Days 15 and 45 were compared with baseline values. Results: Patients underwent three sessions of intense pulsed light treatment. Schirmer test and tear break-up time improved significantly from baseline to Day (D) 45 (8.53 ± 4.31 mm vs 12.6 ± 3.14 mm, 4.53 ± 1.33 sn vs 11.07 ± 2.87 sn, p = 0.003 and p < 0.001). Ocular surface disease index and standard patient evaluation of eye dryness scores improved from baseline to D15 and baseline to D45 (all with p < 0.05). All the subjects reported reduced symptoms by D45. There were no cases of adverse ocular effects. There was no significant change in Oxford grading, lid margin abnormality score, secretion quality, and expressibility degree. Conclusions: Intense regulated pulse light seems a safe treatment procedure for meibomian gland dysfunction, improving tear film quality and reducing symptoms of dry eye.

The use of intense pulsed light therapy in the treatment of refractory meibomian gland dysfunction

“…The clinical safety and tolerability of IPL therapy have been confirmed by numerous clinical studies which report no major adverse events following IPL therapy [14,16,[19][20][21][22][23][24][25][26][27][28]. However, minor or transient side effects, including mild pain, light sensitivity, eyelash loss, eyelid erythema, crusting, hyperpigmentation, and blistering have been described [12,[29][30][31].…”

“…The efficacy of IPL therapy has been reported by a large number of clinical studies. Retrospective and prospective nonrandomized studies have demonstrated that IPL therapy is associated with improvements in dry eye symptomology scores, tear film stability, tear osmolarity, lipid layer thickness, meibomian gland expressibility, meibum quality, eyelid margin vascularity and edema, conjunctival injection, corneal staining, and Schimer test values [12,16,[19][20][21][22][23][24][25][26][27]29,30,[34][35][36][37]. In addition, a recent prospective non-controlled study showed a reduction in tear inflammatory cytokines following IPL therapy [16], while another prospective controlled study reported significant improvement in tear protein and lipid content and composition [21].…”

Dry eye syndrome: Therapeutic challenges and future trends

“…MGE/IPL treatment also showed good clinical evolution after the application of objective and subjective DES tests [13]. However, Craig and Jiang, et al, when doing treatment without MGE, also reported signi icant improvement in the qualitative component of the lipid layer, TFRT, and symptomatic scores [17]. Therefore, further studies with more signi icant sample numbers are needed to evaluate isolated IPL and compared it with MGE-associated IPL [12].…”

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“…They found an improvement in tear ilm rupture time ( TFRT) and in the eyepiece lipid layer. This bene it was assessed from subjective symptom scores, SPEED form [17]. Toyos, et al analyzed 91 patients observed an improvement in TFRT and general symptoms in 87% -93% of cases [8].…”

“…Meanwhile, Toyos reported a minimal reduction in tear osmolarity after IPL [8]. Nevertheless, this data is clinically irrelevant, as it does not interfere with symptoms [12,17]. Guilloto, et al demonstrated the relationship between IPL treatment refractoriness and previous eye surgery.…”