Current developments of intensive pulsed light treatment for dry eye disease and meibomian gland dysfunction

ABSTRACT

Introduction : Dry eye disease (DED) associated with meibomian gland dysfunction (MGD) is one of the most frequent eye diseases, with a prevalence from 10% of the Western population to 70% in Asian countries. Today there is no fully effective treatment and alternatives such as intensive pulsed light (IPL) are being sought. The results with IPL highlights show subjective improvement of the patients when the treatment is carried out with four sessions and with parameters adapted to ophthalmological use. Most studies show improvement in 80–90% of the cases. Regarding the mechanisms of action, there are several possible effects of IPL and the most of them have a common denominator, the reduction of inflammation on ocular surface and around the meibomian glands, favoring tissues regeneration and neuro-trophism who are responsible for the improvement reported by patients.

Areas covered : We analyze possible mechanisms of action of IPL such as the importance of the parameters used for ophthalmological use.

Expert opinion: Still having doubts about the exact mechanism of IPL action, the good clinical results obtained (efficacy and safety) encourage us to think that the incorporation of this new technology can help to improve these patients especially the symptoms they suffer.

KEYWORDS:

• Dry eye disease
• meibomian gland dysfunction
• IPL
• mechanisms of action
• neurotrophism

Article highlights

• Meibomian gland dysfunction (MGD) is a common condition associated with dry eye disease (DED) and represents one of the most frequent eye diseases, even in the scenario of associated pathologies such as Rosacea.

• We highlight the importance of a new treatment for MGD and DED, the Intensive Pulsed Light (IPL), and we review the clinical data and the possible mechanisms of action of this new technology.

• One of the points that we consider most relevant in this article related to the maineffect of IPL should be the anti-inflammatory and regenerative capacity, especially contributing to the neurotrophism of the cornea. This statement is still a hypothesis that must be demonstrated.

• Our personal experience shows the efficacy of the treatment and a low level of complications, despite the fact that side effects have been described, generally when platforms not designed for ophthalmological use or with very aggressive parameters have been used.

• The new IPL systems with technology designed for use in Ophthalmology, such as Thermaeye Plus, allow treating patients with MGD and DED, on all types of skin, even the most pigmented.

• Finally we think that IPL is a very promising technology that can be applied as a single procedure or combined with other treatments according to the need of each patient with MGD and DED.

Declaration of interest

C. Verges is consultant to MDS. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.