Intense pulsed light with meibomian gland expression relieves symptoms of dry eye disease
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This study indicates the efficacy of intense pulsed light treatment combined with meibomian gland expression vs. monotherapy meibomian gland expression in patients with moderate to severe dry eye disease due to meibomian gland dysfunction.
“IPL was particularly effective in improving signs related to the functionality of meibomian glands, such as the number of expressible glands, meibum expressibility and quality,” Rolando Toyos, MD, lead author of the study, told Healio/Ocular Surgery News. “Of note, OptiLight has the ability to rejuvenate meibomian glands that were not functioning prior to treatment.”
According to Toyos and colleagues, intense pulsed light treatment consists of brief pulses of non-coherent and polychromatic light, with wavelength of 500 nm to 1,200 nm, delivered to the periocular area. In previous studies, it was shown to reduce the signs and symptoms of dry eye and was recommended by the Tear Film & Ocular Society’s Dry Eye Workshop II as a second step for the treatment of dry eye disease (DED), after lid hygiene and tear substitutes. However, there had been a lack of randomized controlled trials to properly demonstrate safety and efficacy.
The current study by Toyos and colleagues was carried out in three centers in the U.S. and included 88 patients randomly assigned to receive either meibomian gland expression (MGX) in combination with IPL delivered by the Lumenis OptiLight system or MGX alone. Of these, 82 patients completed all treatment sessions and follow-up.
The combined treatment showed increased efficacy in reducing the signs of DED measured by tear break-up time and meibomian gland score.
Regarding symptoms, the Ocular Surface Disease Index questionnaire and the patient-reported use of artificial tears showed improvement after the treatment, but the difference between the two arms was not significant. In contrast, significantly more relief from symptoms was reported in favor of the combined treatment by the Eye Dryness Score questionnaire. Interestingly, patients in the study arm reported less pain during MGX than patients in the control arm.
No adverse events related to the procedure or the device were reported except for mild skin pain in one patient and moderate bacterial conjunctivitis in another patient.
“The study, which supported FDA approval of the Lumenis OptiLight IPL for the treatment of DED, has been 2 decades in the making. It demonstrates that IPL with the Toyos protocol, that includes MGX as an important part of the treatment regimen, is a valuable tool in the fight against DED, providing our patients with superior results without adverse events,” Toyos said.
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