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Oculoplastics

Intense pulse light has promise as dry eye disease treatment

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Treatment with broadband light (BBL) or intense pulse light (IPL) has the potential to treat refractory meibomian gland dysfunction (MGD) dry eye disease (DED), according to a presentation at ASOPRS 2020 Fall Scientific Symposium by Sandy Zhang-Nunes, MD.

IPL/BBL is not a laser, said Dr Zhang-Nunes, but a flash lamp that emits 400-1400 nanometers wavelengths of light very brightly. Different filters can be applied to focus on different tissues, such as a 560 filter, which utilizes only the red and infrared light spectrum, for the treatment of rosacea and dry eye.

Several studies have previously demonstrated how incidental facial treatment with IPL can improve dry eye symptoms.

Dr Zhang-Nunes and colleagues conducted a study to determine the safety and efficacy of a novel augmented protocol using an IPL machine on the upper and lower eyelids in patients with MGD DED.

This retrospective chart review included 47 patients with MGD DED and/or hyperpigmentation who received IPL/BBL therapy. Patients continued to take their current dry eye treatment in addition to IPL/BBL therapy.

All patients with MGD DED report improvement in their dry eye or blepharitis symptoms with minor adverse effects. An Ocular Surface Disease Index survey taken by participants before and after treatment showed a clinically and statically significant improvement.

Adverse events included mild conjunctival abrasion, temporary eyelash thinning, and temporary hyperpigmentation.

Although no significant adverse events were reported in their study, Dr Zhang-Nunes said that previous ocular damage from IPL has been reported resulting in iritis, iris atrophy, and posterior synechiae, chronic eye pain, and light sensitivity.

“This was likely without eye protection in patients treated at Medspas when IPL was first being used for aesthetics,” she said.

Dr Zhang-Nunes concluded that with the development of safety protocols to protect the eye and eyelashes, IPL treatment of the upper and lower eyelids shows much promise in the treatment of MGD DED.

Reference
Zhang-Nunes S, et al. Safety and efficacy of an augmented intense pulse light protocol for dry eye syndrome and blepharitis. Presented at: ASOPRS 2020 Fall Scientific Symposium.

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