Outcomes of intense pulsed light therapy for treatment of evaporative dry eye disease

Objective To determine the clinical outcomes of intense pulsed light (IPL) therapy for the treatment of evaporative dry eye disease (DED). Design Multicentre cohort study. Participants Patients with a diagnosis of meibomian gland dysfunction (MGD) and dry eye presenting to the ophthalmology clinic at either the Duke Eye Center, Durham, NC, or Matossian Eye Associates’ private practice in Pennington, NJ, and Doylestown, PA. Methods Clinical data were reviewed from 100 patients with diagnosis of MGD and DED who underwent IPL therapy from September 2012 through December 2014 at 1 of 2 centres (Duke Eye Center or Matossian Eye Associates). Demographics, clinical history, examination findings (eyelid and facial vascularity, eyelid margin edema, meibomian gland oil flow, and quality score—all graded on a scale of 0 to 4), tear break up time (TBUT), and ocular surface disease index (OSDI) scoring data were collected from each visit. Results On average, patients underwent 4 IPL sessions. There was significant decrease in scoring of lid margin edema (mean = −0.3; range −1.5 to 0), facial telangiectasia (mean = −0.7; range −2.5 to 0), lid margin vascularity (mean = −1.2; range −2.5 to 0), meibum viscosity (mean = −1.1; range −3 to 0), and OSDI score (mean = −9.6), all with p < 0.001. There was a significant increase in oil flow score (mean = 0.9, range −0.5 to 2) and TBUT (mean = 3.4 seconds, range −2 to 7), both p < 0.001. No significant changes in intraocular pressure or acuity were noted. There were no cases of adverse ocular effects. Conclusions IPL therapy for evaporative DED is a safe procedure. The positive change in objective clinical examination findings and subjective OSDI scoring data suggest that IPL is an effective treatment for patients with evaporative DED.