1
|
Chen R, Lu J, Dong J, Zhu Y. Intense pulsed light therapy for ocular surface diseases. Lasers Med Sci 2024; 39:111. [PMID: 38656565 DOI: 10.1007/s10103-024-04060-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/17/2024] [Indexed: 04/26/2024]
Abstract
Intense pulsed light (IPL) is a non-laser, high-intensity light source that has been shown to play a valuable role in dermatology and has been adopted in ophthalmology for treating meibomian gland dysfunction (MGD). In this review, we discuss the mechanism of action of IPL, including its benefits in ophthalmology. IPL therapy has been shown to improve tear film stability, meibomian gland (MG) function, and subjective symptoms of ocular dryness in MGD patients. Moreover, emerging evidence suggests that IPL therapy is beneficial for other ocular surface diseases, such as blepharitis and chalazia. Hence, it can be inferred that IPL has potential as a therapeutic modality in future applications. Large clinical and experimental trials are needed to exploit the full potential of IPL as a treatment for recurrent chalazia, Sjögren's syndrome, and other causes of dry eye disease (DED). This paper reviews the published literature related to the application of IPL for treating ocular surface diseases.
Collapse
Affiliation(s)
- Ruida Chen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, 1 Xihu avenue, Hangzhou, Zhejiang, 310009, China
- Eye Department, Affiliated Dongyang Hospital, Wenzhou Medical University, Dongyang, China
| | - Jiale Lu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, 1 Xihu avenue, Hangzhou, Zhejiang, 310009, China
| | - Jilian Dong
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yirui Zhu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, 1 Xihu avenue, Hangzhou, Zhejiang, 310009, China.
| |
Collapse
|
2
|
Chen J, Qin G, Li L, Qi Y, Xia Y, Zhang Q, Wu Y, You Y, Yang L, Guo N, Moutari S, Moore JE, Bu S, Xu L, He W, Yu S, Pazo EE, He X. The Combined Impact of Intense Pulsed Light Combined and 3% Diquafosol Ophthalmic Solution on Evaporative Dry Eye: A Randomized Control Study. Ophthalmol Ther 2023; 12:2959-2971. [PMID: 37589932 PMCID: PMC10640412 DOI: 10.1007/s40123-023-00784-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/26/2023] [Indexed: 08/18/2023] Open
Abstract
INTRODUCTION The primary objective of this study is to assess whether the combination of intense pulsed light (IPL) with 3% diquafosol (DQS) ophthalmic solution is more effective than intense pulsed light in alleviating signs and symptoms of dry eye disease (DED). METHODS This randomized study included 66 participants with evaporative dry eye (EDE) who received IPL + DQS therapy (n = 44 eyes), IPL therapy (n = 44 eyes), or sham therapy (n = 44 eyes). All participants were examined at baseline (D0), day 14 (D14), and day 28 (D28) for non-invasive break-up time (NITBUT), tear-film lipid layer (TFLL), corneal conjunctival staining (CS), meibomian gland quality (MGQ), meibomian gland expression (MGEx), and ocular surface disease index (OSDI). RESULTS At day 28, comparison among the IPL + DQS therapy, IPL therapy, and sham therapy found significant differences in the mean NITBUT (12.03 ± 1.27 versus 10.47 ± 3.48 versus 4.57 ± 0.46; p < 0.001), TFLL (2.09 ± 0.29 versus 2.27 ± 0.45 versus 2.89 ± 0.65; p < 0.001), CS (1.43 ± 0.82 versus 1.93 ± 1.32 versus 3.52 ± 1.00; p < 0.001), MGQ (1.55 ± 0.66 versus 1.91 ± 0.77 versus 2.66 ± 0.53; p < 0.001), MGEx (1.27 ± 0.45 versus 1.75 ± 0.44 versus 2.41 ± 0.50; p < 0.001), and OSDI score (19.36 ± 7.01 versus 24.77 ± 4.68 versus 42.61 ± 7.49; p < 0.001); significant improvements in NITBUT, TFLL, CS, MGQ, MGEx, and OSDI were found in the IPL + DQS therapy and IPL therapy, while the sham therapy had no significant improvements. CONCLUSION Combining 3% diquafosol ophthalmic solution with intense pulsed light was superior to IPL therapy alone in relieving the signs and symptoms of patients with severe evaporative DED. TRIAL REGISTRATION Clinical Trials Identifier: NCT05694026.
Collapse
Affiliation(s)
- Jiayan Chen
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, 110034, China
| | - Guanghao Qin
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, 110034, China
| | - Liangzhe Li
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, 110034, China
| | - Yifan Qi
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, 110034, China
| | - Yang Xia
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, 110034, China
| | - Qing Zhang
- Tianjin Medical University, Tianjin, China
| | - Yi Wu
- China Medical University, Shenyang, China
| | - Yue You
- Sinqi Eye Hospital, Shenyang, China
| | | | - Naici Guo
- University of St Andrews, St Andrews, UK
| | | | | | | | - Ling Xu
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, 110034, China
| | - Wei He
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, 110034, China
| | - Sile Yu
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, 110034, China
| | - Emmanuel Eric Pazo
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, 110034, China.
| | - Xingru He
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, 110034, China.
- School of Public Health, He University, Shenyang, 110034, China.
| |
Collapse
|
3
|
Chen J, Qin G, Li L, Qi Y, Che H, Huang H, Xia Y, Zhang Q, Wu Y, Yang L, Moutari S, Moore JE, Xu L, He W, Yu S, Pazo EE, He X. 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. BMJ Open 2023; 13:e073055. [PMID: 37643847 PMCID: PMC10465902 DOI: 10.1136/bmjopen-2023-073055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/27/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION Evaporative 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 been found to be beneficial in reducing signs and symptoms of dry eye. METHODS AND ANALYSIS A randomised clinical trial will be performed at He Eye Specialist Hospital in Shenyang. 360 dry eye disease patients will be equally divided randomly into the IPL group, DQS group (3% diquafosol ophthalmic solution eye-drops) and IPL+group (IPL combined with 3% diquafosol eye-drops). All groups will be followed up for 4 weeks. The primary outcome measures will be the non-invasive tear break-up time and the Ocular Surface Disease Index change from the baseline. The secondary outcome measures willincludeconjunctival and cornea staining with fluorescein and lissamine, meibomian gland function and secretion quality, tear film lipid layer score, tear meniscus height, conjunctival hyperemia (redness score) changes . Adverse events also will be monitored and documented. DISCUSSION This study aimed to assess whether the combination of IPL with 3% diquafosol ophthalmic solution (study group), IPL+ (study group), is more effective than IPL (active control group) or DQS (active control group) in participants with EDE. ETHICS AND DISSEMINATION Management of dry eye with IPL combined with 3% diquafosol ophthalmic solution, registered on 23 January 2023. Ethics approval number: IRB (2022) K029.01. The study's findings will be shared regardless of the effect's direction. TRIAL REGISTRATION NUMBER NCT05694026.
Collapse
Affiliation(s)
- Jiayan Chen
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Guanghao Qin
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Liangzhe Li
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Yifan Qi
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Huixin Che
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - He Huang
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Yang Xia
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Qing Zhang
- Department of Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yi Wu
- Department of Ophthalmology, China Medical University Second Hospital, Shenyang, China
| | - Lanting Yang
- Department of Ophthalmology, Wenzhou Medical University Eye Hospital, Wenzhou, China
| | - Salissou Moutari
- School of Mathematics and Physics, Queen's University Belfast, Belfast, UK
| | | | - Ling Xu
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Wei He
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Sile Yu
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
- School of Public Health, He University, Shenyang, China
| | - Emmanuel Eric Pazo
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Xingru He
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
- School of Public Health, He University, Shenyang, China
| |
Collapse
|
4
|
Zeng H, Gong L. A Review of Applications and Intracellular Mechanisms of Intense Pulsed Light in Eyelid Inflammatory Diseases. Photobiomodul Photomed Laser Surg 2023; 41:104-119. [PMID: 36927050 DOI: 10.1089/photob.2022.0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Objective: To evaluate relevant clinical outcomes and conclude possible mechanisms of intense pulsed light (IPL) in eyelid inflammation. Background: IPL devices were primarily applied in cutaneous vascular malformations and have been used in ocular diseases for about 20 years, mostly including meibomian gland dysfunction (MGD), blepharitis, and ocular rosacea. Recent findings: Seventy-two original clinical researches were included, 57 for MGD, 4 for blepharitis or blepharitis-related keratoconjunctivitis, and 11 for rosacea. Dry eye symptoms, (tear) break-up time (BUT), and meibomian structure and/or functions were improved in most patients, but production of reactive oxygen species is an important link in the photobiomodulation mediated by IPL, which can influence numerous signal pathways to achieve anti-inflammatory, anti-infective, and prodifferentiation effects. Conclusions: The evidence suggests that IPL is an effective therapeutic tool for most patients with MGD, but more clinical evidence is needed for other indications.
Collapse
Affiliation(s)
- Hongya Zeng
- Department of Ophthalmology and Vision Science, the Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Lan Gong
- Department of Ophthalmology and Vision Science, the Eye & ENT Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, China
| |
Collapse
|