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Intense pulsed light, meibomian gland expression reduced tear cytokines
Researchers showed that IL-17A and IL-6 were significantly decreased in the tears of patients with dry eye disease due to meibomian gland dysfunction after intense pulsed light treatment.
The randomized, double-masked, controlled study involved 44 patients (12 male, 32 female), with an active treatment arm receiving three consecutive intense pulsed light (IPL) treatments about 4 weeks apart and control eyes receiving three treatments in the same interval.
Study eyes received IPL treatment depending on the Fitzpatrick skin type per the Toyos protocol, followed by meibomian gland expression on both the upper and lower eyelids using the Arita meibomian gland compressor (Katena Products, Denville, N.J.) with no heat.
Control eyes received sham IPL treatment with handheld flashlights to simulate light flicker.
IPL treatments were administered to the periocular tissues in six treatment areas from nasal to the temporal side on each eyelid, for a total of three treatments about every 4 weeks.
Patients received a total of 12 overlapping IPL pulses in the periocular areas.
When measured in patient tears, the cytokine IL-17A levels on week 4 and week 12 after IPL treatment in the study eyes were -173.49 and -211.75, respectively.
In the control eyes, -64.64 and -89.61 was found during the same period. All values represented a decrease from baseline.
The IPL arm achieved the greater reduction in IL-17A.
In control eyes, there was no significant differences in values at week 4 and week 12.
IL-6 levels and PGE2 were also more significantly reduced in the study arm, according to researchers.
“Potentially, IPL near the lid should cause closing of the abnormal blood vessels secreting inflammatory mediators, reducing the amount of cytokines IL-17A and IL-6 found in the tears, and also decreasing bacterial overgrowth by disrupting bacterial cell walls with targeted wavelengths of light,” researchers wrote.
They concluded that IPL combined with meibomian gland expression is more effective than meibomian gland expression alone in reducing inflammation of patients with dry eye disease caused by meibomian gland dysfunction. – by Abigail Sutton
Disclosures: The researchers report no relevant financial disclosures.