Emmanuel Eric Pazo

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Efficacy of intense pulsed light therapy on signs and symptoms of dry eye disease: A meta-analysis and systematic review

Guanghao Qin, Jiayan Chen, Liangzhe Li, Qing Zhang, Ling Xu, Sile Yu, Wei He, Xingru He, Emmanuel Eric Pazo

Indian Journal of Ophthalmology, 2023 · review · doi:10.4103/ijo.ijo_2987_22 · cited by 35 · Open access (CC BY-NC-SA)

Ocular surface & dry eye

Abstract

This study reviewed the efficacy and safety of intense pulsed light (IPL) for the treatment of dry eye disease (DED). The PubMed database was used to conduct the literature search, which used the keywords "intense pulsed light" and "dry eye disease". After the authors evaluated the articles for relevancy, 49 articles were reviewed. In general, all treatment modalities were proven to be clinically effective in reducing dry eye (DE) signs and symptoms; however, the level of improvement and persistence of outcomes differed amongst them. Meta-analysis indicated significant improvement in the Ocular Surface Disease Index (OSDI) scores post-treatment with a standardized mean difference (SMD) = -1.63; confidence interval (CI): -2.42 to -0.84. Moreover, a meta-analysis indicated a significant improvement in tear break-up time (TBUT) test values with SMD = 1.77; CI: 0.49 to 3.05. Research suggests that additive therapies, such as meibomian gland expression (MGX), sodium hyaluronate eye drops, heated eye mask, warm compress, lid hygiene, lid margin scrub, eyelid massage, antibiotic drops, cyclosporine drops, omega-3 supplements, steroid drops, and warm compresses along with IPL, have been found to work in tandem for greater effectiveness; however, in clinical practice, its feasibility and cost-effectiveness have to be taken into consideration. Current findings suggest that IPL therapy is suitable when lifestyle modifications such as reducing or eliminating the use of contact lenses, lubricating eye drops/gels, and warm compresses/eye masks fail to improve signs and symptoms of DE. Moreover, patients with compliance issues have been shown to benefit well as the effects of IPL therapy is sustained for over several months. DED is a multifactorial disorder, and IPL therapy has been found to be safe and efficient in reducing its signs and symptoms of meibomian gland dysfunction (MGD)-related DE. Although the treatment protocol varies among authors, current findings suggest that IPL has a positive effect on the signs and symptoms of MGD-related DE. However, patients in the early stages can benefit more from IPL therapy. Moreover, IPL has a better maintenance impact when used in conjunction with other traditional therapies. Further research is needed to assess cost-utility analysis for IPL.

Keywords: intense pulsed light therapy; dry eye; meibomian gland dysfunction; Ocular Surface Disease Index; tear film break-up time; adjunctive therapy; meibomian gland expression; cyclosporine

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How to cite

Qin, G., Chen, J., Li, L., Zhang, Q., Xu, L., Yu, S., He, W., He, X., Pazo, E. E. (2023). Efficacy of intense pulsed light therapy on signs and symptoms of dry eye disease: A meta-analysis and systematic review. Indian Journal of Ophthalmology. https://doi.org/10.4103/ijo.ijo_2987_22

@article{qin2023efficacy,
  title = {{Efficacy of intense pulsed light therapy on signs and symptoms of dry eye disease: A meta-analysis and systematic review}},
  author = {Qin, Guanghao and Chen, Jiayan and Li, Liangzhe and Zhang, Qing and Xu, Ling and Yu, Sile and He, Wei and He, Xingru and Pazo, Emmanuel Eric},
  journal = {Indian Journal of Ophthalmology},
  year = {2023},
  doi = {10.4103/ijo.ijo_2987_22},
  url = {https://doi.org/10.4103/ijo.ijo_2987_22},
}

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