The Effectiveness of E>Eye Intense Regulated Pulse Light Therapy in Treating Evaporative Dry Eye Disease among Southeast Asian Patients
DOI:
https://doi.org/10.31584/jhsmr.20241100Keywords:
dry eye, evaporative dry eye, intense regulated pulse light (IRPL), meibomian gland dysfunction (MGD)Abstract
Objective: Since the effectiveness of E>Eye Intense Regulated Pulsed Light (IRPL) therapy in treating evaporative dry eye condition caused by meibomian gland dysfunction (MGD) has not been reported among the Southeast Asian population, this study aimed to retrospectively report the effectiveness of this treatment in addressing evaporative dry eye due to MGD among this population using Tear Check analyzer after three consecutive treatments.
Material and Methods: This is a retrospective study involving 71 male and 107 female patients, aged between 28 and 83 with complaints of dry eye symptoms accompanied by clinical signs of MGD who have been treated with E>Eye IRPL. All patients were treated with IRPL in three consecutive treatments where five overlapping flashes of light were administered on the lower lid and temporal part of each eye on day 1, 15, and 45. Improvement in lower meibomian gland loss, Tear Film Stability Evaluation (TFSE), and non-invasive breakup time (NIBUT) were assessed using the Tear Check analyzer at baseline and after the third treatment session.
Results: Repeated-measure ANOVA showed that the percentage of lower meibomian gland loss and TFSE score significantly improved post-treatment, indicating recovery of the meibomian gland and improved tear stability. McNemar Change Test also showed that the percentage of patients having NIBUT of lower than 6 seconds has significantly reduced post-treatment.
Conclusion: E>Eye IRPL treatment is effective in evaporative dry eye disease caused by MGD among Southeast Asian patients after three consecutive treatments by restoring meibomian gland and tear stability post-treatment.
References
Tawfik A, Pistilli M, Maguire MG, Chen Y, Yu Y, Greiner JV, et al. Association of dry eye symptoms and signs in patients with dry eye disease. Ophthalmic Epidemiol 2024;31:274-82. doi: 10.1080/09286586.2023.2248629.
Vidal-Rohr M, Craig JP, Davies LN, Wolffsohn JS. Classification of dry eye disease subtypes. Contact Lens Anterior Eye 2024:102257. doi: 10.1016/j.clae.2024.102257.
Tsubota K, Yokoi N, Watanabe H, Dogru M, Kojima T, Yamada M, et al. A new perspective on dry eye classification: proposal by the asia dry eye society. Eye Contact Lens 2020;46:S2-13. doi: 10.1097/ICL.0000000000000643.
Sheppard JD, Nichols KK. Dry eye disease associated with meibomian gland dysfunction: focus on tear film characteristics and the therapeutic landscape. Ophthalmol Ther 2023;12:1397-418. doi: 10.1007/s40123-023-00669-1.
Messmer EM. Pathophysiology of dry eye disease and novel therapeutic targets. Exp Eye Res 2022;217:108944. doi: 10.1016/j.exer.2022.108944.
Bron AJ, de Paiva CS, Chauhan SK, Bonini S, Gabison EE, Jain S, et al. TFOS DEWS II pathophysiology report. Ocul Surf 2017;15:438-510. doi: 10.1016/j.jtos.2017.05.011.
Bilkhu P, Wolffsohn J, Purslow C. Provocation of the ocular surface to investigate the evaporative pathophysiology of dry eye disease. Contact Lens Anterior Eye 2021;44:24-9. doi: 10.1016/j.clae.2020.03.014.
Lienert JP, Tarko L, Uchino M, Christen WG, Schaumberg DA. Long-term natural history of dry eye disease from the patient’s perspective. Ophthalmology 2016;123:425-33. doi: 10.1016/j.ophtha.2015.10.011.
Viso E, Rodríguez-Ares MT, Abelenda D, Oubiña B, Gude F. Prevalence of asymptomatic and symptomatic meibomian gland dysfunction in the general population of Spain. Invest Ophthalmol Vis Sci 2012;53:2601-6. doi: 10.1167/iovs.11-9228.
Jie Y, Xu L, Wu YY, Jonas JB. Prevalence of dry eye among adult chinese in the beijing eye study. Eye 2009;23:688-93. doi: 10.1038/sj.eye.6703101.
Lin PY, Tsai SY, Cheng CY, Liu JH, Chou P, Hsu WM. Prevalence of dry eye among an elderly Chinese population in Taiwan: the Shihpai eye study. Ophthalmology 2003;110:1096-101. doi: 10.1016/S0161-6420(03)00262-8.
Siak JJK, Tong L, Wong WL, Cajucom-Uy H, Rosman M, Saw SM, et al. Prevalence and risk factors of meibomian gland dysfunction: the Singapore Malay eye study. Cornea 2012;31:1223-8.
Schein OD, Munuz B, Tielsch JM, Bandeen-Roche K, West S. Prevalence of dry eye among the elderly. Am J Ophthalmol 1997;124:723-8. doi: 10.1016/S0002-9394(14)71688-5.
Stapleton F, Alves M, Bunya VY, Jalbert I, Lekhanont K, Malet F, et al. TFOS DEWS II Epidemiology Report. Ocul Surf 2017;15:334-65. doi: 10.1016/j.jtos.2017.05.003.
Berg EJ, Ying G, Maguire MG, Sheffield PE, Szczotka-Flynn LB, Asbell PA, et al. Climatic and environmental correlates of dry eye disease severity: a report from the dry eye assessment and management (DREAM) study. Transl Vis Sci Technol 2020;9:25. doi: 10.1167/tvst.9.5.25.
Fukuoka S, Arita R, Mizoguchi T, Kawashima M, Koh S, Shirakawa R, et al. Relation of dietary fatty acids and vitamin D to the prevalence of meibomian gland dysfunction in Japanese adults: The Hirado–Takushima study. J Clin Med 2021;10:1-17. doi: 10.3390/jcm10020350.
Dell SJ. Intense pulsed light for evaporative dry eye disease. Clin Ophthalmol 2017;11:1167-73. doi: 10.2147/OPTH.S139894.
Vora GK, Gupta PK. Intense pulsed light therapy for the treatment of evaporative dry eye disease. Curr Opin Ophthalmol 2015;26:314-8. doi: 10.1097/ICU.0000000000000166.
Ribeiro BB, Marta A, Ramalhão JP, Marques JH, Barbosa I. Pulsed light therapy in the management of dry eye disease: current perspectives. Clin Ophthalmol 2022;16:3883-93. doi: 10.2147/OPTH.S349596.
Mejía LF, Gil JC, Jaramillo M. Intense pulsed light therapy: A promising complementary treatment for dry eye disease. Arch la Soc Española Oftalmol English Ed 2019;94:331-6. doi: 10.1016/j.oftale.2019.03.003.
Vigo L, Taroni L, Bernabei F, Pellegrini M, Sebastiani S, Mercanti A, et al. Ocular surface workup in patients with meibomian gland dysfunction treated with intense regulated pulsed light. Diagnostics (Basel) 2019;9:147. doi:10.3390/diagnostics9040147.
Yin Y, Liu N, Gong L, Song N. Changes in the meibomian gland after exposure to intense pulsed light in meibomian gland dysfunction (MGD) patients. Curr Eye Res 2018;43:308-13. doi: 10.1080/02713683.2017.1406525.
Xue AL, Wang MTM, Ormonde SE, Craig JP. Randomised double-masked placebo-controlled trial of the cumulative treatment efficacy profile of intense pulsed light therapy for meibomian gland dysfunction. Ocul Surf 2020;18:286-97. doi: 10.1016/j.jtos.2020.01.003.
Mohd Radzi H, Che Azemin M, Ithnin M, Md-Muziman-Syah M, Khairidzan M. Clinical features of lid margin, meibomian gland and tear film changes in patients with primary pterygium. J Ophthalmic Res Ocul Care 2022;5:92-6. doi: 10.36959/936/576.
Tomlinson A, Bron AJ, Korb DR, Amano S, Paugh JR, Pearce EI, et al. The international workshop on meibomian gland dysfunction: Report of the diagnosis subcommittee. Investig Ophthalmol Vis Sci 2011;52:2006-49. doi: 10.1167/iovs.10-6997f.
Pac C, Ferrari F, Mercea N, Munteanu M. Efficiency of combining heated eye mask with intense pulsed light therapy as a treatment option for evaporative dry eye disease. Rom J Ophthalmol 2024;68:158-65. doi: 10.22336/rjo.2024.29.
Pac CP, Sánchez-González JM, Rocha-de-Lossada C, Mercea N, Ferrari F, Preda MA, et al. Intense pulsed light therapy for dry eye disease: analyzing temporal changes in tear film stability and ocular surface between IPL sessions. Healthc 2024;12. doi: 10.3390/healthcare12111119.
Vision E. The pioneering dry eye treatment. Houdan: ESW vision; 2021:p.15.
Helbig D, Simon JC, Paasch U. Epidermal and dermal changes in response to various skin rejuvenation methods. Int J Cosmet Sci 2010;32:458-69. doi: 10.1111/j.1468-2494.2010.00573.x.
Du YL, Peng X, Liu Y, Ye YF, Xu KK, Qu JY, et al. Ductal hyperkeratinization and acinar renewal abnormality: new concepts on pathogenesis of meibomian gland dysfunction. Curr Issues Mol Biol 2023;45:1889-901. doi: 10.3390/cimb45030122.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
