Prospective Trial of Intense Pulsed Light for the Treatment of Meibomian Gland Dysfunction

Craig, Jennifer P.; Chen, Yen-Heng; Turnbull, Philip

doi:10.1167/iovs.14-15764

Cited by 224 publications

(302 citation statements)

References 31 publications

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“…Abnormal blood vessels release chemokines, cytokines, and other proinflammatory agents. By destroying these blood vessels, a major source of inflammatory mediators is reduced 14. In addition, skin diseases such as rosacea are characterized by an increased epithelial turnover.…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction

Dell¹,

Gaster²,

Barbarino³

et al. 2017

OPTH

121

115

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PurposeThe aim of this study was to estimate the efficacy of intense pulsed light (IPL), followed by meibomian gland expression (MGX), for reducing the number and severity of signs and symptoms of dry eye disease (DED) secondary to meibomian gland dysfunction (MGD).Patients and methodsIn a prospective study conducted in two sites, 40 subjects (80 eyes) with moderate to severe MGD were enrolled. Major inclusion criteria consisted of at least two of the following measures being compatible with DED in both eyes: tear breakup time (TBUT), meibomian gland score (MGS), corneal fluorescein staining (CFS), Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, and tear film osmolarity (TFO). Enrolled patients underwent four treatment sessions, 3 weeks apart. Each treatment included the administration of 10–15 pulses of IPL on the cheeks and nose, followed by MGX of the upper and lower eyelids. TBUT, MGS, CFS, SPEED, TFO, and lipid layer thickness (LLT) were measured at baseline (BL) and at 9, 12, and 15 weeks after BL.ResultsDue to different staining methods used for TBUT measurements, TBUT and CFS were analyzed separately for each site. From BL to the final follow-up, the number of signs compatible with DED decreased from 3.3±0.1 to 1.4±0.1. TBUT improved by +93% (n=38; P<0.0001) and +425% (n=42; P<0.0001) for sites 1 and 2, respectively. SPEED, MGS, and CFS improved by −55% (n=80; P<0.0001), −36% (n=80; P<0.0001), and −58% (n=38; P<0.0001), respectively. In 20 eyes with abnormally elevated TFO at BL, TFO improved by −7% (n=20; P<0.005). LLT did not change (n=38; P=0.88).ConclusionIn subjects with moderate to severe MGD, IPL combined with MGX reduced the number and severity of symptoms and signs of DED. Except for LLT, all examined outcome measures significantly improved after 15 weeks. These results support the efficacy of IPL + MGX in relieving both signs and symptoms of DED secondary to MGD.

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Section: Discussionmentioning

confidence: 99%

Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction

Dell¹,

Gaster²,

Barbarino³

et al. 2017

OPTH

121

115

View full text Add to dashboard Cite

show abstract

“…Toyos et al then showed in 2015 a statistically significant increase in TBUT in 78 patients after IPL [7]. Finally Craig et al showed in 2015 an improvement in lipid layer grade (LLG), tear evaporation rate (TER), tear meniscus height (TMH), and subjective improvements after IPL [8]. This study is to add to this body of evidence to show what effect Intense Pulsed Light therapy has on tear osmolarity.…”

Section: Introductionmentioning

confidence: 86%

The Effects of Intense Pulsed Light on Tear Osmolarity in Dry Eye Disease

Toyos¹,

Briscoe²

2016

J Clin Exp Ophthalmol

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Purpose: In this prospective study we show the influence of Intense Pulsed Light Therapy (IPL) on tear osmolarity, an increasingly important metric of dry eye disease. Previous studies have measured the effectiveness IPL has had on other metrics including tear break up time (TBUT), lipid layer grade (LLG), tear evaporation rate (TER), tear meniscus height (TMH), and subjective responses from patients. Methods:Single center prospective study included 16 patients and 32 eyes. Patient ages ranged from 18 to 90 years old with 75% of participants being female. All patients had an at least one eye with a tear osmolarity of 308 mOsm/L or greater, or had an inter-eye difference in tear osmolarity of 11 mOsm/L or greater. Tear osmolarity was measured bilaterally before a single IPL treatment followed by one drop of topical NSAID. Bilateral tear osmolarity was then measured again one month later.Results: Average tear osmolarity pre-treatment OD was 309 mOsm/L and OS was 306.75 mOsm/L. Average tear osmolarity post-treatment was OD 296.75 mOsm/L and OS 296.06 mOsm/L. Paired t tests were performed showing the change in tear osmolarity to be statistically significant in each eye, OD p=0.0029 and OS p=0.0011. Average inter-eye difference in osmolarity went from 11.81 mOsm/L to 6.81 mOsm/L, statistically significant with p=0.0148. Conclusions:A statistically significant decrease in tear osmolarity from abnormal to normal range as well as a reduction in inter-eye difference demonstrates an improvement in tear film quality after one treatment with IPL, thus suggesting IPL's effectiveness at treating dry eye disease.

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“…Various treatment options for MGD including the LipiFlow instrument, intense pulsed light, eyelid-warming devices, intraductal probing, as well as topical or oral application of drugs have been developed [11][12][13][14][15][16][17][18][19]. Our present results regarding additional instruction by nurses for improving the outcome of treatment with the Azuki-no-chikara eyelid-warming device may also be applicable to other treatment approaches.…”

Section: Resultsmentioning

confidence: 97%

Additional Instruction by a Nurse Enhanced the Effect of Eyelid Warming on Subjective Symptoms in Patients with Meibomian Gland Dysfunction

T¹,

Ideta²,

Mera³

et al. 2018

J Healthc Commun

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Prospective Trial of Intense Pulsed Light for the Treatment of Meibomian Gland Dysfunction

Abstract: Intense pulsed light with multiple sculpted pulses shows therapeutic potential for MGD, improving tear film quality and reducing symptoms of dry eye. ( https://www.anzctr.org.au number, ACTRN12614000162617.).

Cited by 224 publications

References 31 publications

Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction

Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction

The Effects of Intense Pulsed Light on Tear Osmolarity in Dry Eye Disease

Additional Instruction by a Nurse Enhanced the Effect of Eyelid Warming on Subjective Symptoms in Patients with Meibomian Gland Dysfunction

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