Efficacy of IPL Treatment of Dry Eye and Ocular Rosacea
Condition: Ocular Rosacea; Dry Eye
MeSH terms: Dry Eye Syndromes; Keratoconjunctivitis Sicca; Rosacea
Study type: Interventional

Summary: 
      Dry eye disease (DED) is a common condition that causes ocular discomfort and reduces visual
      acuity. The two categories of DED are evaporative dry eye and aqueous deficient dry eye. Both
      conditions can involve pathology of the meibomian glands, lacrimal glands, lids, tear film
      and surface cells. Meibomian gland dysfunction (MGD) is the leading cause of evaporative dry
      eye and contributes to aqueous deficient dry eye. The goal of MGD therapy is to provide long
      term improvement of symptoms for patients by improving the quality of meibum, increasing
      meibum flow, improving tear film stability and decreasing inflammation.

      Commonly used therapies include preservative free drops, omega-3 fatty acid supplementation,
      topical cyclosporine, serum tears, topical azithromycin, oral doxycycline, moisture chambers,
      intraductal probing, lib margin exfoliation, automated thermal pulsation, warm compresses,
      among other. Despite this variety of symptoms, patients often do not experience complete or
      long term relief of symptoms.

      Forced meibomian gland expression (MGX) has been shown to be an effective method of
      rehabilitating meibomian glands and improving dry eye symptoms. The eyelid margins are
      forcefully compressed to express gland contents. Research has shown improvement in patient
      symptoms with the use of MGX.

      Intense pulsed light (IPL) have been used in dermatology to treat various conditions.
      Patients with DED who have tried other therapies and found no relief, often resort to IPL as
      a last resort. Research has shown IPL alone may be effective in improving patient symptoms.
      In addition, such studies have failed to show significant adverse events with the use of IPL.

      Here, we propose a prospective, randomized, case controlled clinical pilot study to examine
      the efficacy for both subjective and objective measures. 20 patients with DED will be
      recruited and will be randomly assigned to one of two groups: MGX alone or MGX with IPL.
      Objective measures will include tear cytokine levels, impression cytology, meibography, tear
      osmolarity and others. Subjective measures will include quality of life screening tools.

      We hypothesize that the use of MGX with IPL will lead to greater improvement in subjective
      dry eye symptoms and objective measures. Given the lack of adverse effects reported in the
      literature, we do not anticipate adverse effects in our study.

      Rochester staff Drs. Faustch and Bourne are providing clinical research advice but have no
      contact with subjects or biospecimens.
    


Intervention name(s): Intense Pulsed Light Treatment (IPL); Meibomian Gland Expression
Intervention type(s): Device; Procedure
Intervention description(s): IPL is a high-intensity light source consisting of visible light in the wavelength range of 515-1200 nm, that is aimed at the eyes. Treatments are spaced four to six weeks apart for a total of 4 treatments.; Manual expression of the meibomian glands by placing the thumb against the lid margin and press firmly against the eyeball to determine the percentage of meibomian pores that are blocked. This assessment is performed on both the upper and lower lid of each eye.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Intense Pulsed Light