2018, Number 6
<< Back Next >>
Rev Mex Oftalmol 2018; 92 (6)
Preliminary results of treatment with Intense Regulated Pulsed Light in Dry Eye Syndrome
Miotto-Montesinos G, Rojas-Alvarez E, Torres-Piedra DM
Language: Spanish
References: 30
Page: 292-299
PDF size: 359.20 Kb.
ABSTRACT
Objective: To describe the preliminary results of the use of Intense Regulated Pulsed Light (IRPL) in patients with Dry Eye
Syndrome due to Meibomian Gland Dysfunction (MGD).
Methods: A descriptive, longitudinal and prospective study was
performed in 32 patients diagnosed with Dry Eye Syndrome, in which treatment with IRPL was applied between April-December
2017 at the Ophthalmological Center Exilaser, in Cuenca, Ecuador. Three treatment sessions were performed on Day
0, Day 15 and Day 45. Absolute and relative frequencies, Pearson test and Fischer test were used for statistical analyses.
Results: After treatment with IRPL, tear film breakup time (BUT) greater than 10 seconds was observed in 87.5% of the
patients, with a correlation between treatment application and a BUT greater than 10 seconds. There was a decrease in the
signs observed in the eyelid margin; this decrease was more evident in blepharitis cases. In 81.3% of the cases, a gentlepressure was enough when performing the glandular expression, in order to obtain a clear liquid in 62.5% of the cases. All
the OSDI test items showed improvement.
Conclusions: Our results show an improvement of the clinical signs and symptoms
of Dry Eye Syndrome due to MGD after a course of three IRPL sessions over a 45-day period. However, more IRPL studies
with a longer follow-up are warranted.
Key words: Intense Pulsed Light Therapy. Dry eye. Meibomian gland
REFERENCES
Lemp MA, Crews LA, Bron AJ, Foulks GN, Sullivan BD. Distribution of aqueous–deficient and evaporative dry eye in a clinic–based patient cohort. Cornea. 2012;31(5):472-78.
Qiao J, Yan X. Emerging treatment options for meibomian gland dysfunction. Clin Ophthalmol. 2013;7:1797-803.
Toyos R, Buffa CM, Youngerman S. Case report: Dry–eye symptoms improve with intense pulsed light treatment. Eye World News Magazine. 2005.
Toyos R, McGill W, Briscoe D. Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction: a 3-year retrospective study. Photomed Laser Surg. 2015;33(1):41-6.
Craig JP, Chen YH, Turnbull PR. Prospective trial of intense pulsed Light for the treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci. 2015;56(3):1965-70.
Vegunta S, Patel D, Shen JF. Combination therapy of intense pulsed light therapy and meibomian gland expression (IPL/MGX) can improve dry eye symptoms and meibomian gland function in patients with refractory dry eye: a retrospective analysis. Cornea. 2016;35(3):318-22.
Ding J, Sullivan DA. Aging and dry eye disease. Exp Gerontol. 2012; 47(7):483-90.
Obata H. Anatomy and histopathology of human meibomian gland. Cornea. 2002;21:S70-4.
Borchman D, Foulks GN, Yappert MC, Milliner SE. Differences in human meibum lipid composition with meibomian gland dysfunction using NMR and principal component analysis. Invest Ophthalmol Vis Sci. 2012;53:337-47.
Graham JE, Moore JE, Jiru X, Moore JE, Goodall EA, Dooley JS, et al. Ocular pathogen or commensal: a PCR–based study of surface bacterial flora in normal and dry eyes. Invest Ophthalmol Vis Sci. 2007;48:5616‑23.
Mathers WD, Shields WJ, Sachdev MS, Petroll WM, Jester JV. Meibomian gland dysfunction in chronic blepharitis. Cornea. 1991;10:277-85.
Knop E, Knop N, Millar T, Obata H, Sullivan DA. The International Workshop on Meibomian Gland Dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. Invest Ophthalmol Vis Sci. 2011;52:1938-78.
Arciniega JC, Wojtowicz JC, Mohamed EM, McCulley JP. Changes in the evaporation rate of tear film after digital expression of meibomian glands in patients with and without dry eye. Cornea. 2011;30:843-7.
Bilkhu PS, Naroo SA, Wolffsohn JS. Effect of a commercially available warm compress on eyelid temperature and tear film in healthy eyes. Optom Vis Sci. 2014;91:163-70.
Jiang X, Lv, H Song H, Zhang M, Liu Y, Hu X, et al. Evaluation of the Safety and Effectiveness of Intense Pulsed Light in the Treatment of Meibomian Gland Dysfunction. J Ophthalmol. 2016;2016:1910694.
Nagymihályi A, Dikstein S, Tiffany J. The influence of eyelid temperature on the delivery of meibomian oil. Exp Eye Res. 2004;78(3):367-70.
Geerling G, Tauber J, Baudouin C. The international workshop on meibomian gland dysfunction: report of the subcommittee on management and treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci. 2011;52(4):2050-64.
Schroeter CA. Haaf–Von Below S, Neumann HAM. Effective treatment of rosacea using intense pulsed light systems. Dermatol Surg. 2005;31:1285-9.
Farrell HP, Garvey M, Cormican M, Laffey JG, Rowan NJ. Investigation of critical inter–related factors affecting the efficacy of pulsed light for inactivating clinically relevant bacterial pathogens. J Appl Microbiol. 2010;108:1494-508.
Chung H, Dai T, Sharma S, Huang YY, Carroll J, Hamblin M. The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng. 2012;40:516-33.
Wakamatsu TH, Dogru M, Matsumoto Y. Evaluation of lipid oxidative stress status in Sjögren syndrome patients. Invest Ophthalmol Vis Sci. 2013;54:201-10.
Hamblin MR, Huang YY, Sharma SK, Carroll J. Biphasic dose response in low level light therapy—an update. Dose Response. 2011;9:602-18.
Hamblin MR, Demidova TN. Mechanisms of low level light therapy. Photobiological Sciences Online; 2008. Disponible en: http://www.photobiology. info/Hamblin.html. Último acceso 21 julio de 2014.
Farivar S, Malekshahabi T, Shiari R. Biological effects of low level laser therapy. J Lasers Med Sci. 2014;5(2):58-62.
Cuerda-Galindo E, Díaz-Gil G, Palomar-Gallego M, Linares-García Valdecasas R. Increased fibroblast proliferation and activity after applying intense pulsed light 800-1200 nm. Ann Anat. 2015;198:66-7.
Goldberg D. Current trends in intense pulsed light. J Clin Aesthet Dermatol. 2012;5(6):45-53.
Prieto V, Sadick N, Lloreta J, Nicholson J, Shea C. Effects of intense pulsed light on sun–damaged human skin, routine, and ultrastructural analysis. Lasers Surg Med. 2002;30(2):82-5.
Kirn T. Intense pulsed light eradicates Demodex mites. Skin Allergy News. 2002;33(1):37.
Lee S, Park K, Choi J. A prospective, randomized, placebo-controlled, double-blinded, and split–face clinical study on LED phototherapy for skin rejuvenation: clinical, profilometric, histologic, ultrastructural, and biochemical evaluations and comparison of three different treatment settings. J Photochem Photobiol B. 2007;88(1):51-67.
Taylor M, Porter R, Gonzalez M. Intense pulsed light may improve inflammatory acne through TNF-α down-regulation. J Cosmet Laser Ther. 2014;16(2):96-103.