Intense pulsed light appears effective for dry eye

Intense pulsed light appears effective for dry eye


Cornea/External Disease


This multicenter controlled trial assessed the efficacy of intense pulsed light (IPL) for treatment of dry eye.

Study design

This study was performed in China. Researchers randomized 120 subjects with dry eye due to meibomian gland dysfunction to either IPL or warm compress followed by manual meibomian expression; there was no placebo arm. Participants received 3 interventions at 3-week intervals. Participants and physicians were not masked to treatment. The primary outcome measure was change in tear break up time (TBUT).

Outcomes

As per most dry eye studies, most participants (80%) were female. The average age of participants was 42 years, which is younger than many other dry eye studies.

Subjects in both arms experienced improvements in symptoms (as measured by the SPEED questionnaire) and a variety of dry eye disease signs including TBUT, meibomian glands yielding secretion scores and corneal staining. TBUT improved by 2.3 and 0.5 seconds in the IPL and control arms, respectively (P<0.001).

Limitations

It is nice to see a randomized control trial with 120 patients for IPL efficacy. However, the study would be stronger if there was a placebo group and if the patients could be masked to treatment—sham pulses of light, and/or applying the meibomian expressor to the eyelid without significant pressure or in a way that does not express—and the observing physicians masked to study timepoint and intervention arm.

Clinical significance

As with many dry eye studies, there are improvements in both study arms. While the 1.8-second difference in TBUT improvement in the IPL arm is definitively statistically significant, clinicians and patients must decide if this difference is clinically significant.