scholarly journals Intense Pulsed Light Therapy with Optimal Pulse Technology as an Adjunct Therapy for Moderate to Severe Blepharitis-Associated Keratoconjunctivitis

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Fang Ruan ◽  
Yunxiao Zang ◽  
Ruti Sella ◽  
Hongshuang Lu ◽  
Shang Li ◽  
...  

Purpose. To evaluate the intense pulsed light (IPL) therapy with optimal pulse technology (OPT, M22™, Lumenis, USA) as an adjunct therapy for the prevention of recurrences in moderate to severe blepharokeratoconjunctivitis (BKC). Methods. This open-label nonrandomized clinical trial evaluated 33 patients diagnosed with BKC. Twenty-one patients received four bilateral OPT therapy sessions with Meibomian gland expression (MGX) (treatment group), and 11 patients received MGX alone (controls). This trial was initiated after a four-week pharmacotherapy for BKC in both groups and was scheduled at four-week intervals. Efficacy outcome measures included meibum quality, Meibomian gland (MG) secretion function, eyelid margin signs, corneal fluorescein staining (CFS) score, noninvasive keratography breakup time (NIKBUT), ocular surface disease index (OSDI) score, Schirmer I test (SIT), classification of tear film lipid layer (TFLL), and Meibomian gland dropout (MGDR). Safety outcome measures included visual acuity, intraocular pressure, eye structure damage, and facial skin appearance at each visit. Results. Quality of meibum, MG expressibility, eyelid margin signs, and OSDI score showed a statistically significant greater improvement in the treatment group after one to three treatment sessions, compared to controls (p<0.05). While these improved in both groups in comparison to baseline, the NIKBUT and upper and lower eyelid MGDRs significantly improved only in the treatment group (p<0.05). No adverse events occurred in both groups. No BKC recurrences were noted in the treatment group. Conclusions. IPL is a safe and effective adjuvant treatment for BKC and possibly more effective in reducing eyelid margin inflammation and prevents recurrences than MGX alone. This trial is registered with ChiCTR-ONN-17013864.

2020 ◽  
Author(s):  
Chen Chen ◽  
Di Chen ◽  
Yu-yu Chou ◽  
qin long

Abstract Purpose: To observe the effectiveness of intense pulsed light (IPL) for meibomian gland dysfunction (MGD) and identify its influencing factors. Methods: Forty-eight eyes of 48 patients with MGD were included. Subjects were followed up 5 times and received IPL during the first three visits. Gender, age, duration of MGD, time of video display terminal usage, and severity of MGD were recorded at baseline. At every visit, Ocular Surface Disease Index (OSDI), eyelid margin abnormality score (EMAS), tear film breakup time (TBUT), Schirmer Ⅰ test (SⅠt) and corneal fluorescein staining (CFS) were recorded. The clinical parameters before and after 3 IPL treatments were compared. Univariate and multivariable logistic regression analyses were performed to explore influencing factors. Results: Compared with baseline, the TBUT was increased and the CFS score and OSDI were significantly decreased on day 45 and day 120 (all P < 0.001). In univariate analysis, among the patients with a younger age (18-39 years), moderate MGD, higher baseline SIt and higher baseline OSDI, the IPL treatment had a higher effective rate (P = 0.032, 0.004, 0.024 and 0.014 respectively). The MGD severity was strongly associated with effective IPL, and patients with moderate MGD had an OR of 5.493 compared with the severe MGD patients (OR = 22.454, 95% CI: 2.890-174.436, P = 0.003). Conclusions: IPL effectively improves clinical symptoms and some signs in MGD patients. Age, MGD severity, baseline SIt and baseline OSDI are potential factors that may influence the effectiveness of IPL. MGD severity is an independent influencing factor.


2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Shanshan Wei ◽  
Xiaotong Ren ◽  
Yuexin Wang ◽  
Yilin Chou ◽  
Xuemin Li

Purpose. Our study aimed to evaluate the efficiency of intense pulsed light (IPL) combined with meibomian gland expression (MGX) in treating meibomian gland dysfunction (MGD). Methods. This study was a prospective interventional study. A total of 53 patients were included in the study and received a series of three treatments at an interval of 3-4 weeks. Follow-up examinations were completed 4 weeks after the last treatment. The Ocular Surface Disease Index (OSDI) questionnaire, tear meniscus height (TMH), tear break-up time (TBUT), slit-lamp examinations, and in vivo confocal microscopy (IVCM) were recorded before and after treatment. Additionally, an artificial intelligence automated software program was applied in our study for corneal nerve analysis. Results. The OSDI score was significantly reduced after the IPL treatment compared with baseline (P<0.001). Meibomian gland assessment scores, including meibum quality and expressibility, eyelid margin abnormalities, and corneal staining, significantly decreased after treatment (P<0.05). Moreover, the corneal nerve fiber length (CNFL) significantly increased after the treatment (P<0.001). Conclusion. Intense pulsed light (IPL) combined with MGX is an effective treatment for MGD, and neurotrophism could be one of the mechanisms of IPL.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaodan Jiang ◽  
Huibin Lv ◽  
Hang Song ◽  
Mingzhou Zhang ◽  
Yan Liu ◽  
...  

Purpose.This study aims to explore the safety and efficacy of a novel treatment-intense pulsed light (IPL) in MGD eyes.Methods.This study is a prospective and open label study. Forty eyes of 40 MGD patients were recruited in the study and received 4 consecutive IPL treatments on day 1, day 15, day 45, and day 75. Ten ocular surface symptoms were evaluated with a subjective face score at every visit. Best spectacle corrected visual acuity, intraocular pressure (IOP), conjunctival injection, upper and lower tear meniscus height (TMH), tear break-up time (TBUT), corneal staining, lid margin and meibomian gland assessments, and meibography were also recorded at every visit, as well as the adverse effects on the eye and ocular surface.Results.Significant improvements were observed in single and total ocular surface symptom scores, TBUT, and conjunctival injection at all the visits after the initial IPL treatment (P<0.05). Compared to baseline, the signs of eyelid margin, meibomian gland secretion quality, and expressibility were significantly improved at every visit after treatments. There was no regional and systemic threat observed in any patient.Conclusion.Intense pulsed light (IPL) therapy is a safe and efficient treatment in relieving symptoms and signs of MGD eyes.


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0246245
Author(s):  
Kyoung Yoon Shin ◽  
Dong Hui Lim ◽  
Chan Hee Moon ◽  
Byung Jin Kim ◽  
Tae-Young Chung

Purpose To investigate the comparative efficacy of intense pulsed light (IPL) therapy alone with that of IPL plus meibomian gland expression (MGX) for meibomian gland dysfunction (MGD). Methods This is a prospective randomized crossover clinical trial. Sixty patients were enrolled and randomly assigned to two groups. All of patients underwent four treatment sessions in total, which were two weeks apart. Group 1 underwent two sessions of IPL therapy with MGX, as well as two sessions of IPL alone. Group 2 received two sessions of IPL therapy alone, and two sessions of IPL therapy with MGX. The following parameters were measured at baseline (BL), 2 weeks after the second treatment session (FU1), and 2 weeks after the fourth treatment session (FU2): tearfilm break-up time (BUT), Oxford grade for corneal staining, meibomian gland expressibility (MGE), meibum quality (MQ), and ocular surface disease index (OSDI). The separate effect of MGX on improvement of MGD parameters was evaluated using generalized estimating equation (GEE). Results The mean age of the participants was 57.52 ± 10.50 years. The BUT, Oxford grade, MGE, MQ, and OSDI of both groups improved significantly (from baseline) by the end of four treatment sessions (FU2 compared to BL; all p-values <0.05). The MGE and MQ significantly improved after the first and second treatment sessions (FU1 compare to BL; all p-values < 0.001). However, the improvement was not statistically significant after the third and fourth treatment sessions (FU2 compared to FU1; p-value of 0.388 for MGE and 0.645 for MQ in group 1, 0.333 for MGE and 0.333 for MQ in group 2). The IPL plus MGX therapy produced greater improvements in the BUT scores than did IPL therapy alone (p = 0.003 by GEE). In contrast, the Oxford grade, MGE, MQ, and OSDI were not influenced by the addition of MGX to IPL (p = 0.642, 0.663, 0.731, and 0.840, respectively by GEE). Conclusion IPL therapy effectively improves the subjective symptoms and objective ocular findings of MGD. MGX enhanced the improvement of BUT driven by IPL therapy. The meibomian gland function (MGE and MQ) recovers faster in response to IPL therapy than did the other parameters.


2021 ◽  
Vol 10 (16) ◽  
pp. 3573
Author(s):  
María T. Iradier ◽  
María Ángeles del Buey ◽  
Cristina Peris-Martínez ◽  
Priscilla Cedano ◽  
David P Piñero

This non-comparative prospective case series was conducted to characterize the clinical impact of intense pulsed light (IPL)-based treatment in dry eyes associated to Meibomian gland dysfunction (MGD), defining the predicting factors for a successful outcome with this therapy in a large case series. A total of 390 eyes (195 patients, range: 23–93 years) received four sessions of Optima IPL system (Lumenis, Yokneam, Israel). Significant changes were observed in tear film osmolarity in both eyes (p < 0.001) and in meibum quality (p < 0.001), with more eyes showing clear or yellow secretions after therapy. Mean change in the ocular surface disease index (OSDI) was −8.61, ranging from −27.00 to 11.00. This change was significantly correlated with the baseline value of OSDI (r = −0.489, p < 0.001). The change in osmolarity correlated significantly with the baseline osmolarity in both eyes (right r = −0.636, left r = −0.620, p < 0.001). A linear predicting model of the change in OSDI with therapy was obtained: change OSDI = 10.99 − 0.35 × OSDI − 1.03 × NIBUTRE-LE (mean non-invasive break up time of right and left eye) −2.03 × Meibum quality grade (p = 0.001; R2: 0.325). In conclusion, the improvement in symptomatology achieved with an IPL-based therapy can be predicted at baseline using a linear model considering the level of MGD and the magnitude of OSDI and NIBUT (non-invasive break-up time).


2022 ◽  
Author(s):  
Man Xu ◽  
Xiaoguang Niu

Abstract Purpose: To observe the therapeutic effect on recurrent corneal erosion syndrome (RCES) by intense pulsed light (IPL) combined with meibomian gland massage. Methods: We recruited 30 patients (30 eyes) with RCES as the RCES group and 31 patients (31 eyes) as the control group. Both the groups received eyelash sampling, Demodex count, meibomian gland infrared photography, and the blepharolipin score. The RCES group was divided into the treatment group and the observation group again. Results: Parameters in the RCES group were higher than those in the control group. The parameters of the treatment group were decreased compared with the observation group. During the follow-up period, one patient in the treatment group relapsed. Conclusion: Meibomian gland dysfunction and Demodex infection may be associated with RCES. IPL combined with meibomian gland massage can significantly improve meibomian gland function, reduce the number of Demodex, and effectively control the relapse of RCES.


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