Management of DE With IPL in Combination With DQS
Condition: Dry Eye
MeSH terms: Dry Eye Syndromes; Keratoconjunctivitis Sicca
Study type: Interventional

Summary: 
      Intense pulsed light (IPL) has been reported to improve signs and symptoms of dry eye (DE).
      Additionally, meibomian gland secretion of lipids has been observed to improve through the
      use of IPL. Diquafosol ophthalmic solution (DQS) stimulates P2Y2 receptors on the ocular
      surface, which enhances mucin secretion from goblet cells. Therefore, tear film stability and
      hydration of the ocular surface can be achieved independent from lacrimal glands function.
      The purpose of this prospective study was to evaluate and compare the effects of IPL (IPL
      group), DQS (DQS group) and IPL in combination with DQS (IPL+ group) in participants with
      persistent DE. Tear film lipid layer (TFLL), non-invasive breakup time (NITBUT), tear
      meniscus height (TMH), corneoconjunctival staining score (CS), meibum gland (MG) function,
      conjunctival hyperemia (RS score), ocular surface disease index (OSDI) will be assessed and
      compared at baseline, day-14, and day-28.
    

Detailed description: 
      Evaporative dry eye (EDE) has been reported to be the most prevalent form of dry eye disease
      (DED), which is primarily caused by meibomian gland hypofunction or meibomian gland
      dysfunction (MGD). MGD is defined as ''a chronic, diffuse anomaly of the meibomian glands,
      often characterized by terminal duct blockage and/or qualitative/quantitative alterations in
      glandular secretion'' by the International Workshop on MGD.These glands are modified
      sebaceous glands that release meibum directly onto the ocular surface. Signs and symptoms of
      EDE and MGD can be addressed by improving the quality and quantity of meibum secretion.

      Intense pulsed light (IPL) is widely used to treat dermatological conditions, and its
      noncoherent polychromatic light source with wide wavelength range of 500-1200 nm has been
      reported to stimulate facial sebaceous glands. The photothermal effect of IPL is postulated
      to relieve inflammation by removing aberrant surface microvasculature and enhances meibomian
      gland function. Furthermore, an increase in fibroblast proliferation, collagen formation and
      local blood flow has been associated with the application of IPL on the skin. Several studies
      have documented the benefits of IPL in alleviating signs and symptoms of DED on the
      periocular skin.

      Diquafosol ophthalmic solution (DQS) is a dinucleotide polyphosphate which a purinoceptor
      agonist, when administered to the ocular surface, it binds to P2Y2 receptors and stimulates
      mucin and tear secretion. The corneal epithelium, conjunctival epithelium, lacrimal gland
      ductal epithelium, meibomian gland sebaceous cells, and meibomian gland ductal cells all
      express the P2Y2 receptor. Subsequently, enhanced secretion of mucin and tear secretion due
      to DQS ophthalmic solution leads to stabilization of the tear film, minimizes tear
      evaporation, and reduces mechanical friction thereby protecting the corneal epithelium.

      The purpose of this study is to assess the management of DE by combining IPL and DQS eye
      drops.
    

Intervention name(s): Intense pulsed light; Diquafosol tetrasodium
Intervention type(s): Device; Drug
Intervention description(s): IPL treatment intensity was chosen based on the Fitzpatrick scale as follows: Fitzpatrick scale I, II, III, 10-15 J/cm2 with a 570-nm filter.; 3% Diquafosol tetrasodium eye drops will be used to assess its usefulness in dry eye signs and symptoms
Other intervention name(s): IPL; Diquas
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: dry eye; intense pulsed light; diquafosol; tear breakup time; ocular surface disease index