Abstract
Purpose :
Intense pulsed light (IPL) and more recently topical radiofrequency (RF) treatment have been shown to be effective for dry eye disease (DED) due to meibomian gland dysfunction (MGD). However, IPL's effect on regeneration of meibomian glands either alone or when used in combination with RF is yet to be understood. Our novel study uses Ocular Surface Disease Index (OSDI) scores and meibography to evaluate changes in patient experience of DED after receiving IPL with RF.
Methods :
Patients (n=11) with a diagnosis of DED and MGD reporting moderate or greater DED symptoms and with OSDI scores over 23 were recruited. Inclusion criteria were defined as patients (minimum 22-years-old) with signs of MGD as detected by biomicroscopy, modified meibomian gland score over 12 in the lower eyelid (LL) of at least one eye, and Fitzpatrick skin type I-IV. Patients were administered 4 treatments of 2 week increments of IPL to the LL, surrounding malar region, and nose followed by RF treatments of 1 and 4mHz for 7 minutes to the inferior, lateral, and superior orbital rim. OSDI questionnaires and meibography were recorded before the first treatment and 4 weeks after the final treatment. Paired t-tests were used to evaluate differences in pre- and post-treatment OSDI scores and meibomian gland area loss, visualized by meibography.
Results :
OSDI scores improved following combined IPL and RF treatment from an average of 60.3 to 31.9 (p=0.010). Meibography also decreased (Figure 1) in both the upper eyelid (UL) and LL of the right (OD) and left eyes (OS). Meibography in OD UL improved from 31.5% to 23.2% (p=0.032), 41.0% to 22.4% in OD LL (p<0.001), 33.2% to 24.2% in OS UL (p=0.002), and 41.0% to 20.3% in OS LL (p<0.001). Meibography of an example patient with improvement from 47.3% to 5.0% is seen in figure 2.
Conclusions :
Combined IPL and RF treatment for DED due to MGD resulted in an improvement on meibography, showing physical, objective evidence of improvement in a critical sign relating to DED and MGD. Improvement in OSDI scores indicated that symptom improvement was also achieved. This novel combination of IPL with topical RF should be considered as a viable treatment option to revitalize meibomian glands, aiding patients with DED and MGD.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.