Intense Pulsed Light Group Research Articles

Management of Glaucoma-Related Dry Eye Disease with Intense Pulsed Light: A Randomized Control Study.

The objective of this study was to assess the effectiveness of intense pulsed light (IPL) therapy in individuals diagnosed with glaucoma and dry eye disease (DED). This randomized control study recruited 22 individuals diagnosed with glaucoma, ranging in age from 33 to 82 years. These participants were undergoing treatment with hypotensive eyedrops and had clinical indications and subjective complaints associated with dry eye. Each patient underwent three sessions of IPL therapy in one eye, while the contralateral eye served as the control eye (CT). The following parameters were assessed at three time points: baseline, week-2, and week-4. These parameters include non-invasive breakup time (NITBUT), tear meniscus height (TMH), conjunctivocorneal epithelial staining score (CS), tear film lipid layer (TFLL), meibomian gland expressibility score (MGEx), Schirmer I test, ocular bulbar redness score (OBRS), and ocular surface disease index (OSDI). Intraocular pressure (IOP), best-corrected visual acuity (BCVA), and corneal endothelial cell count (ECC) were assessed for safety. The clinical trial was registered on 25/12/2023 at ClinicalTrials.gov website (NCT06158984). Comparing baseline and 4-week measurements revealed that the IPL group found significant improvements in NITBUT (IPL: 8.74±2.60 sec. vs CT: 5.76±1.75 sec. p<0.01), TMH (IPL: 0.23±0.05mm vs CT: 0.19±0.06mm, p=0.011), C.S. (IPL: 1.14±0.56 vs CT: 1.95±1.17, p=0.005), TFLL (IPL: 2.91±2.91 vs CT:3.36±0.58, p=0.047), MGEx score (IPL: 1.14±0.35 vs CT: 1.45±0.51, p=0.020) and OSDI scores (IPL: 31.77±15.59 vs 50.59±21.55, p=0.002) significantly improved. Conversely, other parameters showed no significant improvements (p>0.05). The progression of ocular surface disease in individuals using topical anti-glaucoma medication may worsen if the condition is not addressed. Nevertheless, IPL therapy has the potential to result in significant improvements in both objective and subjective measures of dry eye. Best-corrected visual acuity, endothelial cell count, and intraocular pressure were determined to be within the permitted limits. No adverse events were reported during the course of the study.

Outcome of intense-pulsed light therapy versus combination of intense-pulsed light and low-level light therapy for the treatment of meibomian gland dysfunction

Objectives: The objective of this study was to study the efficacy of intense pulsed light (IPL) therapy and a combination of intense pulse light therapy and low-level light therapy (LLLT) in treating meibomian gland dysfunction (MGD). Material and Methods: In this prospective and hospital-based interventional study, 32 patients were enrolled between April 2023 and January 2024 in the Department of Cornea, Sri Sankaradeva Nethralaya, Guwahati. The clinical evaluation was done included the ocular surface disease index (OSDI-6) questionnaire score, tear film break-up time (TBUT), Schirmer test I, slit-lamp examination for lid evaluation to see signs of pitting, telangiectasia, meibomian gland expressibility, meibography (to see gland dropout assessment), and meibomian gland loss percentage (MGL%). The enrolled participants were randomly allocated to receive IPL and combination light therapy (IPL+LLLT) in a 1:1 ratio. Results: Sixty-two eyes of 31 patients were included in this study. In the IPL group, the level of dryness (LOD) improved in nine (56.25%) cases and remained the same in seven cases (73.75%). In the IPL+ LLLT group, the LOD improved in eight cases (53.3%) and remained the same in six (40%) cases. For the right eye (OD), the MGL% was 0.46 ± 0.08 at baseline, which decreased to 0.32 ± 0.07 at six months. For the left eye (OS), MGL% was 0.52 ± 0.09 at baseline, and at six months, it reduced to 0.34 ± 0.08. In OD, MGL% was 0.46 ± 0.06 at baseline, reduced to 0.35 ± 0.12 at six months. In OS, MGL% was 0.49 ± 0.09 at baseline, and at six months, it reduced to 0.35 ± 0.12. In the IPL group, the mean TBUT in OD improved from 3.25 to 5.25 in 1 month. The mean TBUT for OS improved from 4.19 to 6.44 in OS. In the IPL+LLLT group, the mean TBUT in OD improved from 3.2 to 5.2 at one month in OS. The mean TBUT in OS improved from 4.27 to 6 in one month. Conclusion: IPL alone or in combination with LLLT has similar efficacy in treating MGD. There was a reduction in the OSDI score LOD with improved TBUT and decreased MGL% at the end of 1, and six months.

Comparison of non-pharmaceutical treatments for evaporative dry eye: a randomised controlled study protocol

IntroductionThe lipid layer of the tear film is critical to maintaining the integrity of the tear film and absence in the tear film lipid layer (TFLL) is one of the...

Therapeutic effect of intense pulsed light on different types of chalazion in children

This study aims to investigate the effectiveness of Intense Pulsed Light (IPL) therapy for chalazion treatment while also exploring potential variations in sensitivity among different types of chalazion. A total of 149 patients were selected to receive tobramycin combined with IPL treatment and tobramycin combined with hot compress. The treatment groups were divided into cystic type and granulomatous type according to different clinical manifestations. The course of treatment was 3 weeks. The improvement was based on the ultrasound measurement of the masses reduction of more than 50% or disappearance. In the IPL group, 17 (22.67%) cases were cured, 39 (52.00%) were effective, and 19 (25.33%) were ineffective. This includes: cystic type was cured in 3 (15.79%), effective in 5 (26.32%) cases, ineffective in 11 (57.89%) cases; granulomatous type was cured in 14 (25.00%) cases, effective in 34 (60.71%) cases, ineffective in 8 (14.29%) cases. In the hot compress group, 5 (6.76%) cases were cured, 16 (21.62%) cases were effective and 53 (71.62%) cases were ineffective. The cystic type was cured in 2 (8.00%) cases, effective in 3 (12.00%) cases and ineffective in 20 (80.00%) cases; the granulomatous type was cured in 3 (6.12%) cases, effective in 13 (26.53%) cases and ineffective in 33 (67.35%) cases. The cure rate and efficacy rate of IPL treatment is higher than that of hot compress treatment, the treatment effect of IPL treatment on granulomatous chalazion is better than that on cystic type.

Protocol for a parallel assignment prospective, randomised, comparative trial to evaluate the safety and efficacy of intense pulsed light (IPL) combined with 3% diquafosol (DQS) ophthalmic solution in dry eye syndrome

IntroductionEvaporative dry eye (EDE) is common and can lead to ocular pain, decreased visual quality and reduced quality of life. Intense pulsed light (IPL) and 3% diquafosol ophthalmic solution have...

Efficacy and safety of ablative CO2 fractional laser and narrowband intense pulsed light for the treatment of hypertrophic scars: a prospective, randomized controlled trial

Background and Objectives Hypertrophic scarring is a complex process, and numerous methods have been introduced to treat scars. This study aims to evaluate the effect of combined CO2 fractional laser and narrowband intense pulsed light (IPL) compared to IPL alone in the treatment of hypertrophic scars. Materials and Methods This was a prospective, randomized controlled study enrolled 138 patients with hypertrophic scars. The participants were randomly divided into two groups: CO2-IPL and IPL group, and received three sessions at 10–14-week intervals for 3-month follow-up. Two independent plastic surgeons evaluated the treatments using the Patient and Observer Scar Assessment Scales (POSAS). Overall satisfaction was evaluated using the Patient Satisfaction Scale (PSS). Results 101 subjects completed the study. Compared to single IPL, the combination CO2-IPL group showed a significant improvement in itching, color, stiffness, thickness, and irregularity, except for pain, and an enhancement in vascularization, pigmentation, thickness, relief, and pliability of the scar, assessed by POSAS (p < .01). 100% patients in the combination group were satisfied compared to 84% in IPL alone. Conclusion The combination of CO2 fractional laser and narrowband IPL efficiently improved the appearance and profile of hypertrophic scars, offering a comprehensive and reliable approach for scar therapy.

Efficacy of Supramolecular Salicylic Acid 30% Combined with Intense Pulsed Light Compare to Monotherapy Supramolecular Salicylic Acid 30% in Acne Vulgaris Patients

Background: Acne is one of the most common inflammatory skin diseases. Treatment of acne has been challenging due to the multiple factors involved in its pathogenesis. To date, there are several treatments available. They are traditional chemical peeling, laser-based therapy, and so on. Therefore, as several studies reached inconsistent conclusions on which treatment was better, this observational study aimed to compare the efficacy of monotherapy supramolecular salicylic acid (SSA) and the combination of SSA with intense pulsed light (IPL) treatment in acne patients. Methods: 43 patients with acne vulgaris were chosen at the outpatient department of dermatology from October 2019 until December 2020. Patients were divided into 2 groups: group 1, with a total of 23 patients who underwent SSA 30% combined with IPL, and group 2, which will do monotherapy with SSA 30%. Chemical peeling with SSA 30% treatment will be done every 2 weeks, while IPL treatment will be performed every 4 weeks for a treatment course of 8 weeks. Each individual had a VISIA skin examination and an investigator global assessment (IGA) of acne severity scores every four weeks to evaluate clinical improvement and treatment efficacy. Results: Patients in the SSA 30% + IPL group were mostly female, with comparable baseline VISIA skin scores. During 8-week intervals, the SSA 30%+IPL group presented with a greater improvement in overall skin condition measured by VISIA compared to the SSA 30% alone. Although both groups have a positive effect on skin condition improvement, when it comes to acne, gradual improvement in porphyrins and red areas was more obvious in the combined SSA 30%+IPL group compared to SSA 30% alone. Conclusion: The combination of SSA 30% with IPL compared to SSA 30% alone not only provides better treatment for acne vulgaris but also improves skin rejuvenation.

Managing Severe Evaporative Dry Eye with Intense Pulsed Light Therapy.

This study assessed the efficacy and safety of intense pulsed light (IPL) therapy in participants with severe evaporative dry eye disease (DED). This randomized, controlled, single-center study included 49 adult participants (≥ 18years) with severe evaporative DED who received either IPL therapy (n = 56 eyes) or sham therapy (n = 42 eyes) three times. The primary efficacy parameters were ocular surface disease index (OSDI) score, non-invasive tear breakup time (NITBUT), tear film lipid layer (TFLL), conjunctivocorneal staining score (CS), MG Score, meibomian gland (MG) quality, and MG expression score. The mean ages for the IPL group and the control group were 28.05 ± 3.41years (57.1% female) and 28.14 ± 3.53years (52.4% female), respectively. Comparison between the IPL group and the control group found significant differences in the mean OSDI score (22.16 ± 6.08 vs. 42.38 ± 6.60; P < 00.01), NITBUT (6.27 ± 0.84 vs. 3.86 ± 0.68; P < 0.001), TFLL (2.14 ± 0.44 vs. 3.45 ± 0.50; P < 0.001), MG Score (1.34 ± 0.55 vs. 1.88 ± 0.33; P < 0.001), MG quality (1.59 ± 0.07 vs. 2.67 ± 0.08), and MG expression (1.54 ± 0.57 vs. 2.45 ± 0.55) at 12weeks follow-up; however, there was no significant difference in CS (3.32 ± 1.11 vs. 3.74 ± 1.04; P = 0.063). The findings suggest that IPL therapy is clinically beneficial in ameliorating the signs and symptoms of severe evaporative dry eye disease.

The Approach of Intense Pulsed Light Treatment in Patients with Different Severities of Meibomian Gland Dysfunction

PurposeTo make appropriate therapeutic decisions of intense pulsed light (IPL) for meibomian gland dysfunction (MGD) patients.MethodsSixty patients with MGD stage 2–3 were enrolled in IPL Group1 and Self-hygiene Group; 110 patients with MGD stage 3–4 were included in IPL + MGX Group and IPL Group2. Patients in IPL groups received IPL treatment once a month for three times. Meibomian gland expression (MGX) was combined with IPL treatment in IPL + MGX Group. Meibomian gland (MG) functions, MGD stage, associated ocular-surface indexes, and response rate were evaluated.ResultsPopulation characteristics and clinical conditions were comparable between groups. In patients with MGD stage 2–3, both IPL Group1 and Self-hygiene Group improved in MG functions, ocular surface disease index (OSDI) and tear break-up time (TBUT). No statistical difference was found in improvements. Posttreatment response rate was 64.3–66.7% in two groups. In patients with MGD stage 3–4, IPL + MGX Group achieved better improvements in MG expressibility and higher response rate (75.5%) than IPL Group2 (63.3%). Referring to IPL treatment, no statistical difference in MG functions and OSDI improvements was found among MGD patients with different ages, genders, and IPL energy exposure. Patients with higher Fitzpatrick scale improved more in MG expressibility.ConclusionSelf-eyelid hygiene is cost-effective for milder MGD stages. Combining MGX with IPL is necessary in more severe stages. Adult patients with all age and different genders can benefit from IPL treatment. Patients with darker skin can benefit more in expressiblity.

Response of tear cytokines following intense pulsed light combined with meibomian gland expression for treating meibomian gland dysfunction-related dry eye.

PurposeThis study compared the changes in tear inflammatory cytokine levels after intense pulsed light (IPL) combined with meibomian gland expression (MGX) (IPL group) and instant warm compresses combined with MGX (physiotherapy group) as treatments for meibomian gland dysfunction (MGD)-related dry eye disease (DED) to explore their similarities and differences in therapeutic mechanisms.MethodsThis study was a post-hoc analysis of a randomized controlled trial. Thirteen patients with MGD-related DED were enrolled in each group and received three treatments correspondingly with 3-week intervals. The levels of 20 tear cytokines, namely, TNF-α, IL-6, MMP-9, CXCL8/IL-8, CXCL10/IP-10, IL-10, EGF, IL-6R, IL-1β, IFN-γ, lactoferrin, Fas ligand, IL-17A, LT-α, S100A9, LCN2/NGAL, IL-13, IL-12/IL-23p40, Fas, and CCL11/Eotaxin, were measured at baseline, before the second and third treatments, and 3 weeks after the third treatment. The primary outcome was the difference in cytokine levels between baseline and the last measurement, and the trends were analyzed at each measurement point.ResultsAt the last measurement, a significant decrease was observed in all tear cytokines for both IPL and physiotherapy groups compared with baseline. The IPL group showed greater reductions in IL-6, IL-6R, IL-1β, IL-13, and CCL11/Eotaxin than the physiotherapy group. TNF-α, CXCL8/IL-8, CXCL10/IP-10, IL-10, EGF, IL-1β, IFN-γ, and Lipocalin-2/NGAL levels continued to decrease with treatment time. Important interactions were found in the changes of IL-6 and IL-13 levels, where the levels first decreased and then slightly increased in the physiotherapy group after treatment, while they continued to decrease in the IPL group.ConclusionsThe mechanisms of IPL and physiotherapy in treating MGD-related DED were both associated with reducing inflammation, and the superiority of IPL could be attributed to its better inhibitory effect on inflammatory cytokines like IL-6. In addition, several cytokines were on a downward trend during treatment, suggesting that the vicious cycle of DED was suppressed.

The Efficacy and Safety of New-Generation Intense Pulsed Light in the Treatment of Meibomian Gland Dysfunction-Related Dry Eye: A Multicenter, Randomized, Patients-Blind, Parallel-Control, Non-Inferiority Clinical Trial.

IntroductionThis study aimed to evaluate the efficacy and safety of a new-generation intense pulsed light (IPL) device in improving the symptoms and signs of meibomian gland dysfunction (MGD)-related dry eye, and compare it with a traditional IPL device.MethodsThis multicenter randomized controlled trial enrolled 132 patients with MGD-related dry eye from two centers. Patients were randomly assigned into the new-generation IPL (Eyesis) group or traditional IPL (E-Eye) group, and then blinded to receive treatment on days 0 and 7. Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), tear breakup time (TBUT), corneal fluorescein staining (CFS), Schirmer test, and meibomian gland signs were evaluated on days 0, 7, and 14. The primary outcome was defined as the effective rate of treating MGD at day 14. Any adverse events were recorded for safety assessment. Intergroup comparisons and non-inferiority analysis were performed. p values less than 0.05 were considered statistically significant.ResultsBasic information showed no significant difference between treatment groups. The intergroup difference of the effective rate was − 1.7% in the left eye and 1.6% in right eye, verifying the non-inferiority of the Eyesis device (p = 0.927). Significant improvements in OSDI, TBUT, Schirmer test, TMH, CFS, and meibomian gland signs were observed in Eyesis group on days 7 and 14 (all p < 0.05). Compared to the E-Eye group, the Eyesis group achieved more significant improvements in OSDI, TBUT, Schirmer test, TMH, and meibum quality (all p < 0.05). There was no significant difference in the incidences of adverse events between groups (p = 1.000).ConclusionsThe new-generation IPL was effective and safe in relieving the symptoms and signs of MGD-related dry eye, exhibiting a non-inferior effective rate compared to the traditional IPL. Additionally, Eyesis showed more clinical benefits over E-Eye in alleviating symptoms, increasing tear film stability and improving meibomian gland function.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40123-022-00556-1.

Comparison Between Heated Eye Mask and Intense Pulsed Light Treatment for Contact Lens-Related Dry Eye.

Background: Contact lens-related dry eye (CLDE) is common in contact lens (CL) wearers and can lead to ocular pain, decreased visual quality, and reduced quality of life. Objective: The purpose of this prospective, randomized, examiner masked study was to compare the effectiveness of intense pulsed light (IPL) and heated eye mask (HEM) for relieving CLDE. Methods: The final analysis included 60 patients (30 in the IPL group and 30 in the HEM group) who were using CL and had been suffering contact lens discomfort for more than a year. The IPL treatment group had two IPL treatments spaced 3 weeks apart, whereas the HEM group received HEM daily for 6 weeks (42 days). Non-invasive tear break-up time (NITBUT), tear-film lipid layer (TFLL), conjunctival fluorescein staining, meibum gland quality and expression, conjunctival redness score, ocular surface disease index (OSDI), best-corrected visual acuity, endothelial cell count, and intraocular pressure were assessed at baseline: first visit (V1), second visit (V2), and third visit (V3). Results: The mean age of the IPL group was 28.6 ± 4.3 years (16 females, 53%) and that of the HEM group was 28.6 ± 4.2 years (16 females, 53%). Mean NITBUT for the IPL group at V2 was 5.53 ± 0.77 sec (p < 0.001) and at V3 was 7.72 ± 0.88 sec (p < 0.001); the IPL group demonstrated a clinically and statistically significant improvement in mean NITBUT. In addition, the HEM group showed a clinically and statistically significant improvement in mean NITBUT at V3 (5.86 ± 0.76 sec, p < 0.001). At V3, the C-OSDI, TFLL score, and meibum gland quality and expressibility all increased considerably (p < 0.05) in both groups. Conclusions: Our results imply that IPL or HEM treatment of CLDE can be safely used to relieve symptoms of CLDE. In addition, IPL treatment is more effective in improving the general stability of the tear-film and decreasing the need for artificial tears in CLDE.

Management of Post-LASIK Dry Eye with Intense Pulsed Light in Combination with 0.1% Sodium Hyaluronate and Heated Eye Mask.

IntroductionLaser in situ keratomelieusis (LASIK) is one of the most frequently performed refractive treatments. Dry eye (DE) is common in patients after LASIK and can be bothersome postoperatively. Therapies such as intense pulsed light (IPL), sodium hyaluronate (SH) and heated eye mask (HEM) have been reported to improve signs and symptoms of DE .AimThe purpose of this prospective study was to evaluate and compare the effects of IPL and 0.1% SH (IPL group, 50 eyes) and IPL in combination with 0.1% SH and HEM (IPL + group, 50 eyes) in participants with persistent post-LASIK DE.MethodsThe final analysis included 100 patients (100 eyes) who had LASIK for myopic correction and had been experiencing moderate to severe DE following LASIK for over a year. Participants were randomly assigned to either the IPL group (2 IPL sessions) or IPL + group (2 IPL sessions and daily HEM for 4 weeks), and both groups continued the use of daily 0.1% SH (HYLO-COMOD®) preservative-free eye drops. Non-invasive tear break-up time (NITBUT), tear film lipid layer (TFLL), lower tear meniscus height (LTMH), meibomian gland quality (MGQ), meibomian gland expressibility (MGEx), corneal fluorescein staining (CFS), ocular surface disease index (OSDI) and artificial tear usage (ATU) survey were assessed at baseline (BL) and follow-up at 2 (F1) and 4 weeks (F2).ResultsFollowing the treatment protocol, all dry eye (DE) parameters assessed in this study improved significantly (P < 0.05) in both groups at F2 compared with their respective BL measurements. Inter-group comparison at F2 found significant differences in their NITBUT (IPL: 6.06 ± 0.59 vs. IPL +: 6.67 ± 0.86, P < 0.001), TFLL (IPL: 1.90 ± 0.65 vs. IPL +: 1.60 ± 0.64, P = 0.021), LTMH (IPL: 0.186 ± 0.053 vs. 0.204 ± 0.034, P = 0.003), MGQ (IPL: 1.48 ± 0.54 vs. IPL +: 1.26 ± 0.56, P = 0.026), MGEx (IPL: 1.62 ± 0.53 vs. IPL +: 1.44 ± 0.50, P = 0.038) and OSDI (IPL: 32.54 ± 6.85 vs. IPL +: 29.76 ± 4.74, P = 0.001), while CFS score (IPL: 4.02 ± 0.65 vs. IPL +: 3.96 ± 0.73, P = 0.652) and ATU (IPL: 1.88 ± 0.63 vs. IPL +: 1.72 ± 0.50, P = 0.159) showed no significant difference.ConclusionPost-LASIK DE signs and symptoms can be improved by combining therapies such as IPL, HEM and 0.1% SH. Increased TFLL due to a combination of IPL, 0.1% SH and HEM had a greater positive impact on the subjective and objective DE measurements in participants with persistent post-LASIK DE.

Comparison between the Efficacy of Intense Pulsed Light (IPL) versus Photodynamic Therapy with Methylene Blue in the Treatment of Nail Psoriasis

Abstract Background Nail psoriasis is often refractory to traditional treatments, and patients with nail psoriasis usually demand a therapeutic option. Both photodynamic therapy (PDT) and intense pulsed light have been evaluated in nail psoriasis. Objective The objective of this study was to evaluate and compare the efficacy of IPL and methylene blue assisted photodynamic therapy in the treatment of nail psoriasis. Patients and Methods Twenty patients (15 males and 5 females) with mild to moderate psoriasis with nail affection were included in this study. Their age ranged from 24 to 71 years. The PDT used IPL as the light source and methylene blue as photosensitizer. Sessions were applied every 2 weeks for a maximum of 3 months, treating one hand with IPL and the other with PDT. The nails treated were evaluated at baseline, after 2 sessions, after 6 sessions and 3 months after the last treatment session according to the Nail Psoriasis Severity Index (NAPSI) score. Follow-up was performed after 2 sessions, after 6 sessions, and 3 months after the last treatment session. Results A decrease in NAPSI score was observed with both treatments and in both nail bed and nail matrix involvement. No statistically significant difference was found between PDT and IPL as regarding total NPASI score. However, total NAPSI score improved by 61% in MB-PDT group versus 47% in IPL group. Patient follow-up revealed the appearance of new lesions in 3 patients in the group of IPL, and in 1 patient in the MB-PDT after 6 months. Conclusion Intense pulsed light and methylene blue assisted PDT are a promising effective modalities of treatment of nail psoriasis, which are easy to use, safe, and nearly pain-free. This was confirmed by the improvement NAPSI score.

Tear film interferometry assessment after intense pulsed light in dry eye disease: A randomized, single masked, sham-controlled study

BackgroundInadequate meibomian glands (MGs) secretion can lead to dry eye signs and symptoms. Tear film lipid layer (TFLL) secreted by MGs protects and prevents rapid evaporation of tear film. The purpose was to assess TFLL alteration and function in patients with evaporative dry eye (EDE) using tear interferometry after optimal pulse light technology (OPT) intense pulsed light (IPL). MethodsThis prospective randomized examiner-masked sham- controlled study included 86 participants (142 eyes) with DED. IPL or sham procedure was performed on day 0, 21, and 42. Ocular Surface Disease Index (OSDI), non-invasive breakup time (NITBUT), interferometric fringe pattern determined TFLL quality, fluorescein staining (FS), and meibum gland (MG) were assessed at day 0, 21, 42 and 3-month. ResultsAt 3-month, TFLL, NITBUT, MG drop-out, MG quality, MG expressibility, FS and OSDI improved significantly (P < 0.05) in the IPL group, while the sham group had no significant improvements. Except for Meibo-score and FS, all parameters significantly correlated with the improvement in TFLL following IPL treatment. Additionally, artificial tears usage was significantly less in the IPL group from D-42 onwards. ConclusionIPL treatment demonstrated the ability to improve TFLL quality and clinically reduced sign and symptoms of DED thereby reducing the frequency of artificial tears use.

Treatment of contact lens related dry eye with intense pulsed light

AimThe prevalence of contact lens related dry eye (CLDE) is high and can lead to ocular discomfort, reduced quality of vision and life. The aim of this study was to assess the efficacy of intense pulsed light (IPL) treatment in alleviating signs and symptoms of CLDE. DesignProspective, randomised, examiner masked study. MethodsThis prospective study was conducted on 152 eyes of 76 patients (IPL group, n = 76 eyes; control group, n = 76 eyes) wearing contact lens (CL) and experiencing CLDE for more than 1 year. The IPL treatment group underwent two IPL treatment sessions at 3-week intervals while the control group received sham IPL treatment. Best-corrected visual acuity (BCVA), ocular surface disease index (OSDI), non-invasive breakup time (NITBUT), tear film lipid layer (TFLL) quality, fluorescein staining (FS), meibum gland (MG) quality and expression, endothelial cell count (ECC) and intraocular pressure (IOP) were assessed at baseline (D-0), day-21 (D-21) and day-42 (D-42) after IPL treatment. ResultsThe mean age of treatment group and control group was 28.47 ± 5.16 years (21 females, 28 %) and 28.58 ± 4.33 years (23 females, 30 %) respectively. IPL treatment group had clinically and statistically significant improvement in mean NITBUT was observed at D14 (5.24 s, P<0.001) and D28 (6.08 s, P<0.001). OSDI, TFLL score and MG quality and expressibility all improved significantly (P<0.001) at D-42, whereas BCVA, ECC and IOP showed no significant changes at D-21 and D-42 in IPL treatment group. The control group showed no significant improvement in all parameters at D-21 and D-42. ConclusionOur findings suggest that CL related DE can be safely alleviated with IPL treatment as it reduced the severity of symptoms, improved the overall tear film stability and reduced artificial tear use in participants with CLDE.

Comparison of intense pulsed light and near-infrared light in the treatment of dry eye disease: a prospective randomized study.

To compare the efficacy of intense pulsed light (IPL) and near-infrared light (NIL) treatments in alleviating symptoms and signs of dry eye disease (DED). Patients diagnosed with DED at the Peking University Third Hospital Eye Center from January 2019 to October 2019 were randomized to undergo either NIL therapy combined with meibomian gland expression (MGX; NIL Group) or IPL combined with MGX (IPL Group). Treatments were performed three times at 1-month intervals. DED signs and symptoms were evaluated before every treatment. We compared the clinical improvement within and between the groups. Additional comparisons were made according to the meibomian gland (MG) dropout grade. A total of 260 eyes of 130 patients (mean age, 49.68 ± 18.01 years) were included. The dryness and total symptom scores and the MG expressibility and secretion quality (upper and lower eyelids) significantly improved after the three treatments in both groups (p < 0.05). However, IPL had superior efficacy in improving blurred vision, photophobia, burning, increased secretions and the total symptom score at 2 months in patients with more severe MG dropout. Both IPL and NIL treatments were effective in the treatment of DED, but IPL provided greater symptom improvement, particularly in patients with severe MG dropout. NIL can be a new therapeutic option for the treatment of DED.

Comparative Evaluation in Intense Pulsed Light Therapy Combined with or without Meibomian Gland Expression for the Treatment of Meibomian Gland Dysfunction

ABSTRACT Objective To determine whether the combination of meibomian gland expression (MGX) with intense-pulsed light (IPL) has a better efficacy to treat meibomian gland dysfunction (MGD) than IPL alone. Methods One hundred patients with MGD were randomly divided into three groups: MGX, IPL, and IPL+ MGX. Clinical parameters included the Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), noninvasive keratograph tear breakup time (NIBUT), redness, meibomian gland dropout, tear breakup time (TBUT), corneal fluorescent staining (CFS), eyelid margin score, meibomian gland secretion function, and Schirmer I tests were collected before treatment and at 1 and 3 months after treatment. Compare the indexes of each group before and after treatment and also compare the differences of each group on follow-up. Results Compared to the baseline, OSDI, TBUT, and meibomian gland secretion function in IPL group improved throughout the follow-up period (all P < .05) and part of the meibomian gland secretion function increased continuously. OSDI, TBUT, lower eyelid margin scores, and meibomian gland secretion function in IPL + MGX group improved at the both follow-up visits (all P < .05), and continued improvement in meibomian gland secretion function can be observed. Lower meibomian gland dropout and CFS reduced at 1 month and 3 months respectively in IPL ± MGX group (P = .001,P = .001).Compared to IPL group, only CFS has reduction in IPL + MGX group at 1-month (P < .001), CFS, upper and lower MGYCS were improved at the 3 months (P = .037,P = .014, P = .049). Conclusions MGX may have synergistic effect when combined with IPL therapy, and the effect can last at least 3 months.

Proposed Algorithm for Management of Meibomian Gland Dysfunction Based on Noninvasive Meibography.

Although the pathophysiology of meibomian gland dysfunction (MGD) remains incompletely understood, many treatment options have recently become available. According to an international workshop report, treatment selection for MGD should be based on a comprehensive stage classification dependent on ocular symptoms, lid margin abnormalities, meibum grade, and ocular surface staining. However, it is often difficult to evaluate all parameters required for such classification in routine clinical practice. We have now retrospectively evaluated therapeutic efficacy in MGD patients who received five types of treatment in the clinic setting: (1) meibocare (application of a warm compress and practice of lid hygiene), (2) meibum expression plus meibocare, (3) azithromycin eyedrops plus meibocare, (4) thermal pulsation therapy plus meibocare, or (5) intense pulsed light (IPL) therapy plus meibocare. Patients in each treatment group were classified into three subsets according to the meiboscore determined by noncontact meibography at baseline. Eyes in the IPL group showed improvement even if the meiboscore was high (5 or 6), whereas meibocare tended to be effective only if the meiboscore was low (1 or 2). The meiboscore may thus serve to guide selection of the most appropriate treatment in MGD patients. Prospective studies are warranted to confirm these outcomes.

Comparative Study of Diode Laser Versus Intense Pulsed Light (IPL) for the management of Hirsutism in Sulaimani Government

Hirsutism defined as excessive hairiness, hirsutism can negatively affect individuals, particularly females. Hirsutism has been attributed to the presence of high levels of androgen. There are different procedures to treat hirsutism; however, diode laser and intense pulsed light (IPL) are the most common methods. The present study was carried out in order to compare diode laser and IPL procedures regarding their effectiveness in decreasing hirsutism, patient satisfaction, and pain level. The present cross-sectional prospective study was carried out on 66 patients with hirsutism who regularly visited a dermatology clinic in Sulaimani, Kurdistan Region-Iraq over a period of 8 months from February to October 2020. They were assigned into a diode laser group (n=35) and an IPL group (n=31). Each patient had 8 laser sessions, once every month. Required data were collected through photos taken in every session. The collected data were analyzed through Statistical Package for the Social Sciences (version 22.0). The patients’ mean age was 33.12 years. Over 53% and 35% of them had a family history of first- and second- degree hirsutisms, respectively. Both procedures led to good and very good primary outcomes in 43.9% and 36.4% of the patients, respectively. Patient satisfaction was high in 42.4% of them. Our research has showed that IPL has fewer side effects (p-value&lt;0.001), better primary outcome (p-value&lt;0.001), and better patient’s mood (p-value&lt;0.002). The two procedures led to similar level of patient satisfaction, and they were not significantly different in this regard (p-value=0.3). In terms of hair types, the two procedures were significantly different (p-value&lt;0.001), such that IPL was better for thin hair, while diode laser for thick hair. Both diode laser and IPL procedures were found to be efficient in terms of primary outcome, patient satisfaction, and patient’s mood. However, diode laser is proper for dark-skinned patients with thick hair and IPL for thin hair. Diode laser was found to be better choice for our patients because most clients in the region are dark-skinned with thick hair.