July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Safety and Efficacy of Intense Pulsed Light Treatment with Expression for Severe Meibomian Gland Dysfunction of the Upper Eyelids Using a Novel Lightguide
Author Affiliations & Notes
  • Rolando Toyos
    Toyos Clinic, Nashville, Tennessee, United States
  • Melissa Toyos
    Toyos Clinic, Nashville, Tennessee, United States
  • Footnotes
    Commercial Relationships   Rolando Toyos, eyevance (C), lumenis (C), Mallinkrodt (C), shire (C), Spouse- Bausch & Lomb (C), Spouse- Eyevance (C), spouse- Lumenis (C), spouse- Mallinkrodt (C), Spouse- Shire (C), spouse- Sun Pharmaceuticals (C), Sun Pharmaceuticals, Ltd. (C); Melissa Toyos, Bausch & Lomb (F), Digisight (F), Eyevance Pharmaceuticals (C), Lumenis (F), Mallinkrodt (F), Ocugen (F), Opternative (F), Shire (C), Sun Pharmaceuticals, Ltd. (F)
  • Footnotes
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Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6752. doi:
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      Rolando Toyos, Melissa Toyos; Safety and Efficacy of Intense Pulsed Light Treatment with Expression for Severe Meibomian Gland Dysfunction of the Upper Eyelids Using a Novel Lightguide. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6752.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate the safety of and change from baseline of tear break up time (TBUT) in subjects with meibomian gland dysfunction and initial TBUT of 2 seconds or less with a novel lightguide for intense pulsed light treatment and meibomian gland expression.

Methods : Eligible subjects received active treatment consisting of four treatments spaced no fewer than two weeks apart and no longer than four weeks apart. The IPL therapy was performed with Lumenis M22 (Lumenis Ltd, Yokneam, Israel) using a 6 mm clear cylinder SapphireCool for the upper lids with a power setting of 10 mJ/cm2 across the upper eyelids including the tragus for two passes. Patients then received expression of meibomian glands using two cotton tipped applicators. Tear break up time was collected by the investigator.

Results : Ten right eyes and ten left eyes of the same patients with TBUTS of less than or equal to 2 seconds were included in the study. Mean TBUT at baseline was 0.5 seconds in right eyes and 0.6 seconds in left eyes. Using a paired samples t-test, the mean change in TBUT from baseline to final was 4.4 seconds in the right eye and 4.3 seconds in the left eyes. Standard deviations were 2.32 and 2.83, od and os respectively.
Standard error mean was 0.73 and 0.9, od and os respectively. 95% confidence interval of the difference lower and upper were (2.74, 6.06) od and (2.28,6.32) os. P=0.000 od and p=0.001 os.

Conclusions : This pilot study suggests that a new specialized 6 mm cylindrical lightguide for the M22 Lumenis IPL machine is safe and effective in increasing physician measured tear break up times in patients with severe meibomian gland dysfunction and initial tear break up times of 2 seconds or less. Further study is warranted to examine the effect in larger groups of severe patients and in those with less severe dry eye disease.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

 

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