Intense pulse light therapy treatment for refractory dry eye disease due to meibomian gland dysfunction

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.…”

“…Gupta et al [6] reported in a multicenter cohort study involving 100 patients with diagnosis of dry eye and MGD treated with IPL that there was a significant decrease in meibum viscosity scoring (mean: −1.1, range: −3 to 0) and a significant increase in oil flow score (mean: 0.9, range: −0.5 to 2.0). These changes in meibomian secretions are the responsible for the generation of a more consistent lipid layer [5,9,12] leading to increased values of BUT [5,8,9,[11][12][13][14][15]. In the current sample, no significant changes were detected in NIBUT.…”

“…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].…”

Therapeutic Instruments Targeting Meibomian Gland Dysfunction

“…They found an improvement in NIBUT, LLT, and osmolarity and suggested that patients with lower BUT responded better to the treatment. Finally, Yurtasser et al [ 75 ] (III) found an improvement in symptoms and NIBUT at 1 month and an improvement in symptoms, NIBUT, MG dropout, and corneal staining in the mild and moderate MG atrophy groups, lasting up to 12 months. No improvement was observed in patients with severe MG atrophy.…”

“…The number of sessions varies among three [ 74 , 76 ], four [ 73 , 77 , 78 ], and eight [ 79 ], and the period between sessions can fluctuate between 15 [ 73 , 74 , 77 ], 21 [ 78 , 79 ] and 30 [ 76 , 77 ] days. Finally, the number of flashes is not standardized, 4–5 being the most frequent [ 73 – 75 , 80 ], although other authors double the flashes or apply even more [ 78 , 79 ].…”