Efficacy of intense pulsed light therapy on signs and symptoms of dry eye disease: A meta-analysis and systematic review

Abstract

This study reviewed the efficacy and safety of intense pulsed light (IPL) for the treatment of dry eye disease (DED). The PubMed database was used to conduct the literature search, which used the keywords “intense pulsed light” and “dry eye disease”. After the authors evaluated the articles for relevancy, 49 articles were reviewed. In general, all treatment modalities were proven to be clinically effective in reducing dry eye (DE) signs and symptoms; however, the level of improvement and persistence of outcomes differed amongst them. Meta-analysis indicated significant improvement in the Ocular Surface Disease Index (OSDI) scores post-treatment with a standardized mean difference (SMD) = −1.63; confidence interval (CI): −2.42 to −0.84. Moreover, a meta-analysis indicated a significant improvement in tear break-up time (TBUT) test values with SMD = 1.77; CI: 0.49 to 3.05. Research suggests that additive therapies, such as meibomian gland expression (MGX), sodium hyaluronate eye drops, heated eye mask, warm compress, lid hygiene, lid margin scrub, eyelid massage, antibiotic drops, cyclosporine drops, omega-3 supplements, steroid drops, and warm compresses along with IPL, have been found to work in tandem for greater effectiveness; however, in clinical practice, its feasibility and cost-effectiveness have to be taken into consideration. Current findings suggest that IPL therapy is suitable when lifestyle modifications such as reducing or eliminating the use of contact lenses, lubricating eye drops/gels, and warm compresses/eye masks fail to improve signs and symptoms of DE. Moreover, patients with compliance issues have been shown to benefit well as the effects of IPL therapy is sustained for over several months. DED is a multifactorial disorder, and IPL therapy has been found to be safe and efficient in reducing its signs and symptoms of meibomian gland dysfunction (MGD)-related DE. Although the treatment protocol varies among authors, current findings suggest that IPL has a positive effect on the signs and symptoms of MGD-related DE. However, patients in the early stages can benefit more from IPL therapy. Moreover, IPL has a better maintenance impact when used in conjunction with other traditional therapies. Further research is needed to assess cost-utility analysis for IPL.

Complex therapy of the evaporative form of dry eye syndrome in patients after keratorefractive surgery

“…Conflict of interest: the authors declare no conflict of interest. [8] Figure 1. Vicious cycle of evaporative dry eye and meibomian gland dysfunction [8] Офтальмология у пациентов с ССГ [14].…”

“…[8] Figure 1. Vicious cycle of evaporative dry eye and meibomian gland dysfunction [8] Офтальмология у пациентов с ССГ [14]. Применение слезозаместительной терапии при ДМЖ продиктовано необходимостью связывания водного и липидного компонентов слезы для поддержания баланса между липидным и водно-муциновым слоем, что осуществляется благодаря прилегаю щей к водно-муциновому слою гидрофильной области амфифильных полярных липидов, присутствующих в липидном слое (рис.…”

“…Кроме того, сообщалось об улучшении субъективной остроты зрения и качества зрения после лечения IPL у пациентов с CCГ [33,34]. Положительный результат применения IPL также наблюдался у пациентов, не склонных к соблюдению режима закапывания, и отмечалась меньшая зависимость от слезозаместительной терапии, поскольку эффект IPL-терапии сохраняется в течение нескольких месяцев [8].…”

Protocol for a parallel assignment prospective, randomised, comparative trial to evaluate the safety and efficacy of intense pulsed light (IPL) combined with 3% diquafosol (DQS) ophthalmic solution in dry eye syndrome

“…Nevertheless, the likelihood of hyperpigmentation, blisters and a burning sensation cannot be ruled out in certain instances, particularly in patients with darker skin phototypes. 57 Potential corneal and/or retinal toxicity will be assessed and monitored continuously. Therefore, this study aims to assess the effectiveness of the combination of IPL with 3% DQS ophthalmic solution, providing more options for treatment.…”

Intense pulsed light treatment for the management of meibomian gland dysfunction

“…In terms of other short-time adverse effects, the most common symptoms reported are mild pain, focal areas of eyelash loss, erythema, edema, hyperpigmentation, corneal/conjunctival abrasion, and hair loss at the brow and forehead [51,52]. Rarely is pain caused by IPL substantial enough to require discontinuation of the treatment [33].…”