IPL therapy outperforms punctal plugs in treating evaporative dry eye, study finds

Intense pulsed light (IPL) therapy shows superior efficacy in improving the quality of life (QOL) for patients with evaporative dry eye compared to punctal plug insertion, according to a study that found that IPL therapy led to significant improvements in QOL, as measured by the Ocular Surface Disease Index (OSDI) questionnaire, and resulted in increased tear breakup time (TBUT) without any reported complications. In contrast, while punctal plugs also improved QOL for some patients, they were associated with a higher risk of complications.

In the study, patients diagnosed with moderate-to-severe evaporative dry eye completed the questionnaire before and after treatment with IPL therapy (Group 1, n = 15) and silicone punctal plug insertion (Group 2, n = 15).

Results indicated significant improvements in QOL for all patients in Group 1 following IPL therapy, with a decrease in mean OSDI score from 56.9 to 22.9 (P = 0.001). In contrast, Group 2 patients experienced QOL enhancements in 80% of cases, albeit to a lesser extent, with a mean OSDI score dropping from 53.8 to 31.7 (P = 0.017).

IPL therapy demonstrated significant improvements in TBUT within Group 1, increasing from a mean of 3.2 seconds to 5.9 seconds (P = 0.001). Conversely, Group 2 exhibited no significant changes in TBUT values (mean TBUT pretreatment: 3.6 seconds; posttreatment: 3.9 seconds; P = 0.654). Notably, complications such as punctal granuloma and proximal canalicular obstruction occurred in 13.3% of Group 2 patients, while no adverse effects were reported in Group 1.

Reference
Elbakary MA, Shalaby OE, Allam WA, et al. Quality of life improvement in dry eye patients after intense pulsed light therapy compared to punctal plugs. Oman J Ophthalmol. 2024;17(1):108-112. doi: 10.4103/ojo.ojo_85_23. PMID: 38524331; PMCID: PMC10957059.