Intense pulsed light (IPL) treatment improved tear film lipid layer (TFLL) quality and reduced dry eye disease (DED) symptoms, researchers found in a study published in Contact Lens and Anterior Eye.

Most cases of DED are evaporative dry eye (EDE), which is typically the result of meibomian gland dysfunction (MGD). To treat EDE and MGD, ophthalmologists must improve meibum excretion. Researchers have postulated that IPL could improve TFLL quality.

The investigators included 86 adult patients aged 21 to 34 years. Each had a Fitzpatrick skin type of 1 to 4 and had been diagnosed with dry eye (DE) based on ocular symptoms, non-invasive tear film breakup time (NITBUT) of less than 5 seconds and fluorescein staining score of at least 1 (on a scale of 0 to 9), visualization of meibomian glands on meibography image, and bilateral diagnosis of MGD.


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The researchers created 2 randomly assigned treatment groups, which each underwent at least 2 treatments of 12 pulses of bilateral IPL from the preauricular area and across the cheek or sham treatments. The treatments and sham treatments occurred at days 0, 21, and 42, and an eye exam followed each treatment.

The group that underwent IPL experienced significant improvements in TFLL, NITBUT, and meibo-score compared with the sham group following each treatment point. 

Meibo-score, composed of meibum gland (MG) dropout, MG quality, and MG expression, was significantly improved in the IPL group compared with the sham group at each point. 

The OSDI scores significantly improved at day 42 and 3 months in the IPL group compared with the sham group. Use of artificial tears significantly decreased in the IPL group at day 21 and day 42 compared with the sham group.

Change in TFLL was significantly correlated with change in NITBUT, MG quality, MG expression, OSDI score, and AT use. 

“This current study found NITBUT after IPL treatment significantly increasing, as previously reported by other researchers, showing an improvement of tear film stability,” the investigators report. “Because of increased meibum secretion and change in the viscosity and quality of meibum, the tear film becomes more stable, resulting in an improvement in dry eye symptoms.”

The team adds that longer follow-up might show a significant correlation between improvement in TFLL and additional MG improvements.

Study limitations included range in age of patients who participated and lack of inclusion of DED’s inflammatory markers and osmolarity.

Reference

Song Y, Yu S, He X, et al. Tear film interferometry assessment after intense pulsed light in dry eye disease: A randomized, single masked, sham-controlled study. Cont Lens Anterior Eye. Published online August 22, 2021. doi:10.1016/j.clae.2021.101499