Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction

Dry eye syndrome: Therapeutic challenges and future trends

“…Combination therapy was superior in improving the lipid component of the tear ilm compared with MGE alone. 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].…”

“…The lack of collagen ibers causes a reduction in meibomian pumping, leading to a decrease in TRFL (tear ilm rupture time). From photomodulation, there is stimulation of ibroblast proliferation and increased collagen concentration in the skin, increasing the pressure required on the eyelid margin and normalizing glandular drainage [5][6][7]13]. Demodex is a type of ectoparasite present in the sebaceous and meibomian glands.…”

“…Recently, a randomized, double-blind study demonstrated a reduction in cytokines (IL6 and IL17) and prostaglandin E2 with the use of IPL. Dry eye cytokine analysis caused by MGD showed an increase in CX3CL1, IL-1Ra, IL-6, IL-8 / CXCL8, and EGF [12][13][14]. These markers should be further investigated for understanding the antiin lammatory mechanism and posttreatment measurement and a possible relationship with IPL failure [18][19][20].…”

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].…”