Pulslichttherapie („intense pulsed light“) als Therapieoption bei der Behandlung der Meibom-Drüsen-Dysfunktion

Schuh, Angela; Priglinger, Siegfried; Messmer, Elisabeth M.

doi:10.1007/s00347-019-00955-z

Cited by 8 publications

(4 citation statements)

References 32 publications

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“…In 2002, it was found incidentally that dry eye symptoms significantly improved in patients with rosacea treated with IPL [5]. Since then, several studies have investigated the effect of IPL on treating MGD [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] and demonstrated a significant improvement in both symptoms and signs. e recognized mechanisms for IPL treatment of MGD include the following.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Effect of Intense Pulsed Light (IPL) Combined with Meibomian Gland Expression (MGX) on Meibomian Gland Dysfunction (MGD)

Wei

Ren

Wang

et al. 2020

Journal of Ophthalmology

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Purpose. Our study aimed to evaluate the efficiency of intense pulsed light (IPL) combined with meibomian gland expression (MGX) in treating meibomian gland dysfunction (MGD). Methods. This study was a prospective interventional study. A total of 53 patients were included in the study and received a series of three treatments at an interval of 3-4 weeks. Follow-up examinations were completed 4 weeks after the last treatment. The Ocular Surface Disease Index (OSDI) questionnaire, tear meniscus height (TMH), tear break-up time (TBUT), slit-lamp examinations, and in vivo confocal microscopy (IVCM) were recorded before and after treatment. Additionally, an artificial intelligence automated software program was applied in our study for corneal nerve analysis. Results. The OSDI score was significantly reduced after the IPL treatment compared with baseline (P<0.001). Meibomian gland assessment scores, including meibum quality and expressibility, eyelid margin abnormalities, and corneal staining, significantly decreased after treatment (P<0.05). Moreover, the corneal nerve fiber length (CNFL) significantly increased after the treatment (P<0.001). Conclusion. Intense pulsed light (IPL) combined with MGX is an effective treatment for MGD, and neurotrophism could be one of the mechanisms of IPL.

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Section: Introductionmentioning

confidence: 99%

Therapeutic Effect of Intense Pulsed Light (IPL) Combined with Meibomian Gland Expression (MGX) on Meibomian Gland Dysfunction (MGD)

Wei

Ren

Wang

et al. 2020

Journal of Ophthalmology

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“…Sinnvoll in diesem Stadium kann auch eine apparative automatisierte physikalische Lidtherapie (LipiFlow, Fa. TearScience Inc., Morrisville, NC, USA, Johnson&Johnson Vision, Neuss) sein oder eine Lichttherapie mit Starklicht (Intense Pulsed Light, IPL) [40] oder eine Low-Level-Light-Therapie (LLLT) [41].…”

Section: Stadiengerechte Sicca-therapieunclassified

Entzündung beim Trockenen Auge – Informationen zu Diagnostik und Therapie durch Nutzung der wissenschaftlichen Online-Informationsplattform OSCB-Berlin.org

Knop

2020

Klin Monbl Augenheilkd

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ZusammenfassungDas Trockene Auge gilt als häufigste Erkrankung in der Augenheilkunde. Sein pathophysiologisches Verständnis wurde in den letzten Jahrzehnten durch intensive Forschung wissenschaftlich klinisch und experimentell grundlegend erweitert. Das Spektrum der Erkrankung reicht von einer einfachen bis zu einer schwerwiegenden und komplexen Störung der funktionellen Anatomie der Augenoberfläche mit typischer Disparität zwischen den klinischen Befunden und der Symptomatik des Patienten. Die chronische Verletzung des Gewebes treibt verschiedene selbstverstärkende Regelkreise (vicious circles) an, die insgesamt zur progressiven Verschlimmerung des Krankheitsbildes führen. Dies kann Entzündungsvorgänge auslösen, die zur Entstehung einer immunmodulierten Entzündung und eines chronischen Schmerzsyndroms führen können. Beides ist relativ therapieresistent in der üblichen klinischen Praxis. Ein besserer Einblick in die pathophysiologischen Grundlagen hat viele Ansätze für Neuerungen in Diagnostik und Therapie des Trockenen Auges ermöglicht. Dennoch erfordert die Sicca-Praxis typischerweise hohen Zeitaufwand, bietet im Alltag meist nur symptomatische Therapie und ist oft unbefriedigend für den Patienten und auch für seinen Arzt. Daher erscheint das Trockene Auge nicht selten als ein eher schwer überschaubares und schwieriges Krankheitsbild. Die wissenschaftliche Informationsplattform des Berliner Forschungszentrums für die Augenoberfläche (Ocular Surface Center Berlin, OSCB-Berlin.org) hat sich zum Ziel gesetzt, das Verständnis der funktionellen Interaktionen an der Augenoberfläche zu verbessern und damit auch der Mechanismen bei der komplexen Pathophysiologie des Trockenen Auges und der chronischen Entzündung. Dies ist die Basis für einen aktuellen Überblick über Diagnostik und Therapie des Trockenen Auges auf verschiedenen Ebenen, die ein Verständnis für Kliniker und auch für Patienten erlauben.

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“…From a technical perspective, the IPL therapy is based on the delivery of intense pulses of noncoherent light with wavelengths from 500 to 1200 nm that are normally applied to the lower lid and temporal lid margin. This process is repeated in 2-4 sessions [29]. This irradiation of filtered polychromatic broad-bandwidth wavelengths with varying pulse durations generates various effects that contribute to its therapeutic properties: Meibomian glands warming that facilitates the expressibility and release of the meibum inside, improvement of the function of Meibomian glands, reduction of tear osmolarity, reduction of proinflammatory mediators contributing to dry eye, improvement of the cellular functions including fibroblasts regeneration, collagen synthesis, motility in immunoregulatory cells and photobiomodulation [15,30,31].…”

Section: Introductionmentioning

confidence: 99%

Characterization and Prediction of the Clinical Outcome of Intense Pulsed Light-Based Treatment in Dry Eye Associated to Meibomian Gland Dysfunction

Iradier¹,

Buey

Peris-Martínez

et al. 2021

JCM

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This non-comparative prospective case series was conducted to characterize the clinical impact of intense pulsed light (IPL)-based treatment in dry eyes associated to Meibomian gland dysfunction (MGD), defining the predicting factors for a successful outcome with this therapy in a large case series. A total of 390 eyes (195 patients, range: 23–93 years) received four sessions of Optima IPL system (Lumenis, Yokneam, Israel). Significant changes were observed in tear film osmolarity in both eyes (p < 0.001) and in meibum quality (p < 0.001), with more eyes showing clear or yellow secretions after therapy. Mean change in the ocular surface disease index (OSDI) was −8.61, ranging from −27.00 to 11.00. This change was significantly correlated with the baseline value of OSDI (r = −0.489, p < 0.001). The change in osmolarity correlated significantly with the baseline osmolarity in both eyes (right r = −0.636, left r = −0.620, p < 0.001). A linear predicting model of the change in OSDI with therapy was obtained: change OSDI = 10.99 − 0.35 × OSDI − 1.03 × NIBUTRE-LE (mean non-invasive break up time of right and left eye) −2.03 × Meibum quality grade (p = 0.001; R2: 0.325). In conclusion, the improvement in symptomatology achieved with an IPL-based therapy can be predicted at baseline using a linear model considering the level of MGD and the magnitude of OSDI and NIBUT (non-invasive break-up time).

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Pulslichttherapie („intense pulsed light“) als Therapieoption bei der Behandlung der Meibom-Drüsen-Dysfunktion

Cited by 8 publications

References 32 publications

Therapeutic Effect of Intense Pulsed Light (IPL) Combined with Meibomian Gland Expression (MGX) on Meibomian Gland Dysfunction (MGD)

Therapeutic Effect of Intense Pulsed Light (IPL) Combined with Meibomian Gland Expression (MGX) on Meibomian Gland Dysfunction (MGD)

Entzündung beim Trockenen Auge – Informationen zu Diagnostik und Therapie durch Nutzung der wissenschaftlichen Online-Informationsplattform OSCB-Berlin.org

Characterization and Prediction of the Clinical Outcome of Intense Pulsed Light-Based Treatment in Dry Eye Associated to Meibomian Gland Dysfunction

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