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Sravanthi Vegunta, Joanne F Shen; Early treatment outcomes in dry eye patients treated with intense pulsed light (IPL) therapy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2018.
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The purpose of this retrospective study is to describe the early treatment outcomes for meibomian gland dysfunction and ocular rosacea in dry eye patients treated with IPL therapy.
The medical records of 43 dry eye patients in a referral practice treated with monthly IPL and meibomian gland expression at Mayo Clinic in Arizona between January and July 2013 were retrospectively examined to determine outcomes. Nineteen charts had adequate records for inclusion in data analysis. Demographics, ocular histories, SPEED2 scores, slit lamp exam, and meibomian gland evaluation (MGE) were reviewed at baseline and after IPL treatment.
The average patient age was 68 years (32-84). The number of women was 17 (89.5%) and the number of men was 2. 78.9% of patients had previous ocular surgery and/or blepharoplasty. The average number of IPL treatments was 3 (1-5). Of the 19 patients, 7 were good responders (≥40% decrease in SPEED2), 6 were mild responders (1-39% decrease in SPEED2), 5 were non responders or adverse responders (no change or decrease in SPEED2), and 1 was intolerant (could not tolerate the pain of gland expression). 85.7% of good responders, 66.7% of mild responders, and 40% of adverse or non responders noticed transient symptom improvement after first treatment. Twenty-five of the 38 eyes (65.8%) had improved MGE score. The average improvement in MGE score was 18.5%. There were no pathologic changes on slit lamp exams after therapy. 92.9% (13/14) of eyes of good responders had improved MGE; however, only 66.7% (8/12) of mild responders had improved MGE.
Evaporative dry eye is the most common cause of dry eye. IPL is an FDA approved, non-reimbursable treatment for rosacea and is used to treat the ocular rosacea component of dry eye. Most patients who receive IPL are treated with this method as a last resort after trying several other conventional dry eye therapies. In this study, 68.4% of patients had a positive response to IPL. Anecdotal improvement in symptoms after one treatment can be a prognostic indicator of a patient’s responsiveness to IPL. This study is limited by its small population and retrospective nature. Future prospective controlled studies are needed to validate the findings. In summary, IPL treatment for ocular rosacea can improve dry eye symptoms.
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