Referencias

Luz Pulsada Intensa: Seguridad y Eficacia

~ 2020 ~

Evaluation of the efficacy of optimal pulsed technology treatment in patients with cataract and meibomian gland dysfunction in the perioperative period.

Ge et al.

BMC Ophthalmology (2020) 20:111. https://doi.org/10.1186/s12886-020-01357-5

A prospective randomized controlled study. Cataract surgery can aggravate MGD and is detrimental to ocular surface health. The postoperative comparison between the IPL treatment group and the conventional surgery group showed that the patients in the IPL treatment group had a better subjective feeling and ocular surface state after surgery.

(Case Report) Real-time video microscopy of in vitro demodex death by intense pulsed light.

Fishman et al.

Photobiomodulation, Photomedicine and Laser Surgery (2020). https://doi.org/10.1089/photob.2019.4737

In-vitro study. The video directly demonstrates the effect of IPL on a live Demodex mite extracted from a freshly epilated eyelash. The results showed that IPL application with settings identical to those used for treatment of DED due to MGD causes a complete destruction of Demodex.

Efficacy and safety of intense pulsed light in patients with meibomian gland dysfunction – a randomized, Double-mask, sham-controlled clinical trial.

Piyacomn et al.

Cornea 2020;39:325-332. http://www.corneajrnl.com/

A prospective randomized controlled study. The study showed that conventional lid hygiene could improve meibomian gland function, and IPL treatment to the skin below the lower eyelid made the improvement faster and of greater magnitude. In conclusion, IPL is effective and safe to manage patients with MGD at any stage of the disease, especially stage 4, in which other methods may have limited efficacy.


~ 2019 ~

Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction.

R. Arita et al.

The Ocular Surface 17 (2019)104-110. https://doi.org/10.1016/j.jtos.2018.11.004

A prospective randomized controlled study. The combination of IPL and MGX improved homeostasis of the tear film and ameliorated ocular symptoms in patients with refractory MGD and is thus a promising modality for treatment of this condition.

Intense pulsed light therapy with optimal pulse technology as an adjunct therapy for moderate to severe blepharitis-associated keratoconjunctivitis.

Ruan et al.

Journal of Ophthalmology (2019). Article ID3143469, 10 pages. https://doi.org/10.1155/2019/3143469

A prospective non-randomized controlled study. The mechanism behind IPL is the induction of selective photothermolysis of oxyhemoglobin of the yellow light, transforming luminous energy into heat energy, enabling coagulation and ablation of abnormal capillaries which also decreases the dissemination of inflammatory factors. This is seen in its effect over various diseases, including rosacea. It is also utilized for the reduction of Demodex folliculorum mites and Bacillus oleronius bacterium which are potential mediators of blepharitis and MGD, and it has a temporary local thermal effect which can melt meibum to facilitate its secretion.

Clinical results of intraductal meibomian gland probing combined with intense pulse light in treating patients with refractory obstructive Meibomian gland dysfunction: a randomized controlled trial.

Huang et al.

BMC Ophthalmology (2019) 19(11):211. https://doi.org/10.1186/s12886-019-1219-6

A prospective randomized controlled study. The surprising efficacy of IPL in easing the symptoms of MGD patients can be mainly attributed to its effect of vasculature destruction and meibum melting. Lid telangiectasia is a common characteristic of MGD, and these tiny vessels along the eyelid margin also increase the accessibility of inflammatory mediators, resulting in aggravated chronic inflammation above the palpebral edge or within the glands.

Meibum expressibility improvement as a therapeutic target of intense pulsed light treatment in meibomian gland dysfunction and its association with tear inflammatory cytokines.

Choi et al.

Nature Scientific Reports. (2019) 9:7648. https://doi.org/10.1038/s41598-019-44000-0

A prospective single arm study. Patients with low meibum expressibility and tear film instability experienced greater improvement in symptoms after IPL treatment. The improvement in meibum expressibility was also associated with a decrease in tear inflammatory cytokines levels. Therefore, meibum expressibility improvement might be a good therapeutic target of IPL treatment in patients with MGD and DED, and could be an indicator of ocular surface inflammation during IPL treatment.

Effect of intense pulsed light therapy on tear proteins and lipids in meibomian gland dysfunction.

Ahmed et al.

Journal of Ophthalmic and Vision Research 2019; 14(1):3-10. https://doi.org/10.4103/jovr.jovr_12_18

A prospective single arm study. The results revealed significant improvements in the tear protein content of patients with MDG after IPL therapy. The decrease in the protein content of tear in eyes with MGD and the improvement after IPL therapy may directly affect the composition of tear proteins.

Evaluation of the safety and efficacy of intense pulsed light treatment with meibomian gland expression of the upper eyelids for dry eye disease.

Toyos et al.

Photobiomodulation, Photomedicine and Laser Surgery 2019; 37(9):527-531. https://doi.org/10.1089/photob.2018.4599

A prospective single arm study. This pilot study suggests that a new specialized 6 mm cylindrical handpiece for the M22 Lumenis IPL machine is safe and effective in increasing physician-measured tear breakup time as well as several scales of the symptoms of ocular dryness. The IPL therapy was performed with a Lumenis M22 xenon-based micropulsed IPL utilizing a 590 nm filter with a 6 mm clear SapphireCool cylindrical lightguide for the upper lids with a fluence of 10J/cm2 across the upper eyelids, including the tragus for two passes.


~ 2018 ~

Multicenter Study of Intense Pulsed Light Therapy for Patients With Refractory Meibomian Gland Dysfunction.

Arita et al.

Cornea (2018), 37(12):1566 http://www.corneajrnl.com/

A prospective single arm study. The efficacy of IPL therapy for patients with dry eye due to MGD was discovered serendipitously during IPL treatment of facial rosacea. Subsequent studies found that IPL is effective for improvement of subjective symptoms and objective findings in patients with mild to moderate MDG or dry eye. Indeed, the combination of IPL and meibomian gland expression (MGX) was found to ameliorate dry eye symptoms and to improve meibomian gland function in patients with refractory dry eye, a cohort that included not only individuals with MGD but also those with graft-versus-host disease or Sjögren syndrome. The efficacy of such combination treatment in patients with moderate to advanced MGD was also recently demonstrated in a single-center study.

Intense pulsed light applied directly on eyelids combined with meibomian gland expression to treat meibomian gland dysfunction.

Rong et al.

Photomedicine and Laser Surgery 2018; 36(6), 326-332. https://doi.org/10.1089/pho.2017.4402

A prospective paired-eye study. In the study eyes we noticed that even though glands loss was similar in the upper and lower eye lids (1.43 ±0.59 vs. 1.48±0.76), the improvement in gland secretion function was significantly greater in the lower eyelids than in the upper eyelids. Due to gravity and eyelid movement, the tear meniscus in the upper eyelid is smaller than that in the lower eyelids, and consequently, contains fewer inflammatory factors.

Changes in the Meibomian Gland after exposure to Intense Pulsed Light in Meibomian Gland Dysfunction (MGD) Patients.

Y. Yin et al.

Current Eye Research. 2018; 43(3), 308-313. https://doi.org/10.1080/02713683.2017.1406525

A prospective randomized controlled study. Compared to routine physical therapy (such as eyelid hygiene) for MGD, IPL treatment is more time-efficient and has better efficacy, lasting more than 6 months.


~ 2017 ~

Analysis of cytokine levels in tears and clinical correlations after intense pulsed light treating meibomian gland dysfunction.

Liu et al.

American Journal of Ophthalmology 2017; 183: 81-90 http://dx.doi.org/10.1016/j.ajo.2017.08.021

A prospective paired-eye study. The study results suggest that IPL can significantly reduce inflammatory markers in tears of patients suffering with DED owing to MGD after IPL treatment. These findings indicate that IL-17A and IL-6 play roles in the pathogenesis of DED owing to MGD, and the reduction of the inflammatory factors is consistent with the improvement of partial clinical symptoms and signs.

Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction,

Dell et al.

Clinical Ophthalmology 2017:11, 817-827 http://doi.org/10.2147/OPTH.S130706

A prospective single-arm study. The authors examined how Optima IPL combined with MGX affected each of these two conditions separately. Conditions described in this article was related to Tear Film Osmolarity (TFO): one, an eye was considered as abnormal with respect to tear osmolarity if TFO was ≥310 mOsml/L, and two, if the difference of TFO between eyes is ≥8 mOsnl/L. While a 7% reduction in TFO may seem modest, according to Versura et al, a change from 322 to 298 mOsml/L, corresponds to a change from severe to mild DED.


~ 2016 ~

The effects of intense pulsed light on tear osmolarity in dry eye disease.

Toyos & Briscoe

Journal of Clinical & Experimental Ophthalmology 2016, 7:619 http://doi.org/10.4172/2155-9570.1000619

A prospective single-arm study. A statistically significant decrease in tear osmolarity from abnormal to normal range as well as a reduction in inter-eye difference demonstrates an improvement in tear film quality after one treatment with IPL, thus suggesting IPL’s effectiveness at treating dry eye disease.

Combination therapy of intense pulsed light therapy and meibomian gland expression (IPL/MGX) can improve dry eye symptoms and meibomian gland function in patients with refractory dry eye: a retrospective analysis.

Vegunta et al.

Cornea 2016, 35(3):318-322 http://www.cornealjrnl.com/

A retrospective study. The authors showed that the combination of IPL and MGX can significantly improve symptoms (in 89% of patients) and meibomian gland dysfunction (in 77% of patients in at least 1 year).


~ 2015 ~

Prospective trial of intense pulsed light for the treatment of meibomian gland dysfunction.

Craig et al.

Investigative Ophthalmology & Visual Science 2015 ; 56(3), 1965-1969 http://www.iovs.org/

A prospective paired-eye study. This article is the first report of a prospective study of IPL for MGD. The significantly increased lipid quantity on the tear film surface following treatment suggests that outflow of meibum from the glands has been facilitated by the IPL treatment. The benefits, furthermore, appeared to be cumulative , such that after a course of 3 treatments over 45 days, 82% of treated eyes exhibited significant improvements in their LLG (lipid layer grade) of at least one grade, and 65% exhibited an improvement of at least 2 lipid grades.

Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retrospective study.

Toyos et al.

Photomedicine and Laser Surgery 2015; 33(1), 41-46 http://doi.org/10.1089/pho.2014.3819

A retrospective study. IPL has been used in dermatology practices for several years as a treatment for rosacea and acne. IPL uses a Xenon flashlamp to emit wavelengths of light from 400 to 1200 nm. When placed of the light, a filter restricts the wavelength to the visible range of ~500 nm. When applied to the skin, this 500 nm light causes the blood cells in the abnormal telangiectasias to absorb the light, coagulate and finally to close the blood vessels. In 2002 the author began to observe that some of our patients treated with IPL showed improvement in MGD and DED. Over the years, they have perfected the technique and technology to maximize results and minimize complications. IPL seems to liquefy the abnormal viscous meibum and dilate the glands. Patients report that gland expression relieves their dry eye symptoms more effectively than IPL alone, with little of the usual discomfort.