Intense pulsed light therapy reduces the severity of dry eye syndrome in meibomian gland dysfunction: a prospective study

Session Details

Session Title: Cornea Medical II

Session Date/Time: Tuesday 13/09/2016 | 08:00-10:30

Paper Time: 09:24

Venue: Hall C3

First Author: : S.Dell USA

Co Author(s): :                        

Abstract Details

Purpose:

To estimate the efficacy of intense pulsed light (IPL) with optimal pulse technology (OPT), followed by meibomian gland expression, for reducing the number and severity of signs and symptoms of dry eye syndrome (DES) secondary to meibomian gland dysfunction (MGD).

Setting:

Starting from September 2015, a prospective study was conducted in parallel at Dell Laser consultants (Austin, Texas) and at Gaster Eye Center (Beverly Hills, California)

Methods:

Forty subjects with moderate to severe MGD were enrolled. Major inclusion consisted of at least 5 active meibomian glands in each lower eyelid, and at least 2 of the following outcome measures being compatible with DES in both eyes: tear breakup time (TBUT), Meibomian gland score (#glands, meibum quality, lid margin inflammation), Corneal Fluorescein Staining (CFS), SPEED questionnaire, and tear osmolarity. Compatibility with DES was determined from standard cut-offs used in the literature. Eligible patients underwent 4 IPL sessions 3 weeks apart. Follow-ups occurred at 9, 12 and 15 weeks after baseline. The primary endpoint was the change in TBUT.

Results:

In 12 subjects (24 eyes) who completed all treatments and follow-ups by March 6 2016: From baseline to final follow-up, TBUT increased from 6.0 (95%CI: 3.2-8.7) to 20.5 sec (95%CI: 12.7-28.3) (paired t-test: p<0.001); the proportion of subjects with TBUT compatible with DES decreased from 92%6% to 38%10% (Chi-square test: p<0.0001). SPEED, MG score and CFS score decreased from 13.7 to 6.8 (p<0.0001), 22.0 to 13.9 (p<0.0001), and 5.9 to 3.4 (p<0.001), respectively. Tear osmolarity decreased from 306 to 296 mOsm/L (p<0.05). The difference in tear osmolarity between the 2 eyes decreased from 12.0 to 7.3 mOsm/L (p<0.0001).

Conclusions:

In subjects with moderate to severe MGD, a combined therapy of IPL and meibomian gland expression significantly reduced the number, and improved the severity, of symptoms and signs of DES. In each of the examined outcome measures (TBUT, SPEED, MG score, CFS, tear osmolarity), there was a gradual and significant improvement in the average value, and a major reduction in the proportion of subjects with values compatible with DES. On average, the number of symptoms/signs compatible with dry eye was more than halved. These results support the hypothesis that IPL is effective for the management of DES due to MGD.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented