Safety and Efficacy of an Augmented Intense Pulse Light Protocol for Dry Eye Syndrome and Blepharitis

Abstract

Objective: We evaluated the safety and efficacy of an augmented BroadBand Light (BBLÔ) protocol on the upper and lower eyelids in improving meibomian gland dysfunction (MGD) and/or dry eye disease (DED). Background: DED, often associated with MGD, can cause significant morbidity and accounts for 3.54 billion U.S. dollars of health care spending yearly. Intense pulsed light (IPL) has been used to treat MGD DED with some success. BBL therapy, a high-quality IPL machine, shows much promise for decreasing inflammation and redness in rosacea, as well as hyperpigmentation from sun damage. Methods: A retrospective medical chart review was performed for MGD DED and/or hyperpigmentation patients who received BBL therapy between January 1, 2015, and February 28, 2020. Inclusion criteria included patients who underwent at least one BBL treatment. Each treatment involved the upper and lower eyelids, as well as cheeks, nose, and face. Each MGD DED subject completed the Ocular Surface Disease Index (OSDI) and underwent pre-and post-treatment standard clinical examinations. Results: Forty-seven patients had treatment without significant adverse effects; all patients with MGD DED reported improvement in their dry eye or blepharitis. BBL was determined to be a safe and effective treatment. There were no changes in visual acuity (p = 0.555) and OSDI scores were improved (p = 0.016). There was one case each of mild corneal/conjunctival abrasion, temporary hyperpigmentation, and two of temporary eyelash thinning. Patients with MGD also showed significant improvement in blepharitis and reduced hordeolum frequency after BBL treatment. Conclusions: This novel IPL/BBL protocol appears safe and effective for treating dry eye and blepharitis.

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

“…This non-comparative prospective case series has shown, as in previous studies, that IPL-based therapy can be an effective treatment for dry eye with MGD associated [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In agreement with the mechanism of action of the IPL technology, a significant change was observed in the secretion of the meibomian glands, with more eyes showing clear or yellow secretions after therapy.…”

“…All these clinical changes after IPL were associated to an improvement of symptomatology evaluated by means of the OSDI score, as in previous studies using IPL for the treatment of dry eye with MGD [6,[10][11][12][13][14][15][16]. This change in OSDI with IPL was significantly correlated with the level of baseline OSDI, with more potential of improvement in those eyes with severe dry eye-related disturbances.…”

“…The analysis of the outcomes of IPL treatment in this last condition led to the discovery of the potential of this therapeutic option for the treatment of dry eye due to Meibomian gland dysfunction (MGD) [2][3][4]. Since then, a great variety of studies have been conducted to demonstrate the efficacy of IPL for the treatment of dry eye associated to MGD without [5][6][7][8][9][10][11][12][13][14][15][16] and with the combined meibomian gland expressibility (MGX) [17][18][19][20][21][22]. The American Academy of Ophthalmology have recently published a report on the efficacy of IPL treatment for MGD, concluding that the existing body of the scientific literature demonstrates improvements in the signs of symptoms of this condition, although methodological limitations and potential conflicts of interest were present in some studies [23].…”

Safety and Efficacy of BroadBand Intense Pulsed Light Therapy for Dry Eye Disease with Meibomian Gland Dysfunction

“…Although the exact mechanism of action remains unknown, many studies since then have reported significant improvements in dry eye symptoms, tear break-up times, lipid layer grade and thickness, and/or meibomian gland function, with limited adverse events. 2,[15][16][17][18][19][20][21][22][23] These studies have used a variety of IPL devices, including M22™ (Lumenis, Israel), 17,20,22 Quadra Q4 (DermaMed Solutions, USA), 2,14 E>Eye (E-SWIN, France), 15,16,18,21 and customized treatment protocols, ranging in energy levels, treatment frequencies, number of treatment sessions and treatment durations.…”

“…BroadBand Light (BBL™) is a high-quality, enhanced IPL modality that uses polychromatic, noncoherent, continuous light waves from the visible (420 nm) to the infrared (1400 nm) spectrum. 23 BBL-IPL is known for its relative safety, high skin coverage rate, and minimal recovery time. 20 As compared to IPL alone, BBL offers larger spot sizes, a wider range of filters and a continuous pulsing mode, which enhance the efficacy and safety of treatments.…”