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Combined low level light therapy and intense pulsed light therapy for the treatment of meibomian gland dysfunction

Authors Stonecipher K, Abell TG, Chotiner B, Chotiner E, Potvin R

Received 27 April 2019

Accepted for publication 21 May 2019

Published 11 June 2019 Volume 2019:13 Pages 993—999


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Karl Stonecipher,1 Thomas G Abell,2 Bennett Chotiner,3 Erik Chotiner,3 Rick Potvin4

1Physicians Protocol, Greensboro, NC, USA; 2Abell Eyes, Lexington, KY, USA; 3Memorial Eye Institute, Harrisburg, PA, USA; 4Science in Vision, Akron, NY, USA

Purpose: To evaluate the effects of combined intense pulsed light therapy (IPL) and low-level light therapy (LLLT) on clinical measures of dry eye related to severe meibomian gland disease (MGD) in subjects unresponsive to previous medical management.
Patients and Methods: This was a retrospective chart review of patients treated by 4 physicians at 3 centers. All patients were documented treatment failures with traditional pharmaceutical therapy. They all had their MGD evaluated before treatment using a grading scale (0–4), tear breakup time in seconds and the Ocular Surface Disease Index (OSDI) questionnaire. To be included, all patients had to have had a short course of adjunct pharmaceutical or device-related therapy, along with a combined IPL/LLLT treatment. As well, a second MGD evaluation with the same three measures had to have been conducted 1–3 months post treatment.
Results: A total of 460 eyes of 230 patients were identified for inclusion in the data set. Mean OSDI scores were significantly lower after treatment; 70.4% of patients had pretreatment OSDI scores indicative of dry eye; this dropped to 29.1% of patients after treatment. A 1-step or greater reduction in MGD grading was observed in 70% of eyes, with 28% of eyes having a 2-step or greater reduction. Tear breakup time was ≤6 seconds in 86.7% of eyes pretreatment, dropping to 33.9% of eyes after treatment. There were no ocular or facial adverse events or side effects related to the combined light treatment.
Conclusion: The use of combined IPL/LLLT for the treatment of severe MGD appears to be beneficial in patients who have failed topical and/or systemic therapy.

Keywords: LLLT, low level light therapy, IPL, intense pulsed light, meibomian gland dysfunction, ocular surface disease index

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