Опыт применения трансдермальной светоимпульсной терапии при лечении дисфункции мейбомиевых желез у пациента с болезнью трансплантата (клинический случай)

Abstract

Purpose. To present an experience of using transdermal pulsed light therapy in combination with meibomian glands secret expression in a patient with transplant disease. Clinical case. Patient M., 63 years old, was referred with a diagnosis: condition after penetrating keratoplasty, transplant disease, keratomalacia, dry eye syndrome, meibomian glands dysfunction. In addition to standard ophthalmological examination, a keratographic examination of the anterior surface of the eye using Keratograph 5M device (Oculus) and meibography in infrared light were carried out. Based on the results of the examination, it was decided to enhance conservative therapy with transdermal pulsed light therapy in combination with meibomian glands secret expression. Results. Intense pulsed light therapy using M 22 System (Lumenis, Israel) with meibomian glands secret expression and conservative treatment led to a decrease of patient's subjective complaints (feeling of pain, burning), an improvement in the quality and amount of meibomian glands secret, and decrease of the ocular surface inflammation. The effect of treatment was cumulative and remained stable for at least six weeks after the treatment. Conclusion. The advantages of transdermal pulsed light therapy are pathophysiological approach, elimination of chronic inflammation, long-term effect after treatment (3–6 months) due to cumulative effect and restoration of meibomian glands unction. This clinical case demonstrates the effectiveness of an integrated approach in the treatment of patients with chronic inflammation of the anterior ocular surface and a burdened surgical history, including cases of preparation for repeated reconstructive interventions. Key words: dry eye syndrome, transdermal pulsed light therapy, meibomian glands dysfunction.