Intense pulsed light with meibomian gland expression (IPL-MGX) did a better job of managing symptoms of dry eye in patients with ocular rosacea than MGX did alone, according to a study in Clinical Ophthalmology. A research team published these results after investigating tear film transforming growth factor-beta (TGF-β) and ocular microbiome changes after using IPL-MGX.
The investigators explored IPL’s efficacy by randomly assigning 20 patients to receive either IPL-MGX or MGX alone. Patients were examined, treated, and given the ocular surface disease index (OSDI) survey every 4 to 6 weeks for 4 total treatments. Researchers collected tear film and conjunctival samples at the first and last visits and analyzed them for TGF-β concentration and 16s rRNA amplicon sequencing of the ocular microbiome. Investigators found that patients who received IPL-MGX had significantly greater improvement in symptoms. This study revealed no significant change in tear TGF-β concentration in either group, according to researchers. All patients experienced a significant reduction in several virulent bacteria, but no statistically significant difference between the treatment groups.
However, OSDI revealed a more significant improvement in symptoms after IPL-MGX (P =.030) than MGX alone. No significant difference was seen in mean TGF-β1, 2, or 3 concentration after IPL-MGX (P =.385, P =.709, and P =.948, respectively). Quantities of Clostridium, Klebsiella, Brevibacterium, Lactobacillus, Neisseria, Streptococcus, Corynebacterium, Butyricicoccus, and Actinomyces were significantly reduced from baseline in both groups, but without a significant difference between the 2 treatment groups.
The research team concluded that prospective studies with larger sample sizes are needed to further investigate cytokines and IPL in patients suffering from ocular rosacea with dry eye symptoms.
Researchers noted several limitations to this study’s findings, including its small sample size and limited generalizability. In addition, patients weren’t blinded to their assigned treatment groups, there was no placebo IPL treatment, and the study didn’t seek to eliminate confounders. Further, patients received post-treatment anti-inflammatories, which may have influenced inflammation and microbiome. Investigators also note that extracting a significant volume of tear fluid from patients was not always possible, and eyelid margin swabs yielded insufficient sample volume for microbiome analysis, so only conjunctival epithelium samples were used.
Sagaser S, Butterfield R, Kosiorek H, et al. Effects of intense pulsed light on tear film tgf-β and microbiome in ocular rosacea with dry eye. Clin Ophthalmol. 2021;15(1):323-330. doi:10.2147/OPTH.S280707.