Therapeutic effects of low-color-temperature light-emitting diodes on dry eye.

BACKGROUND: As a new technology for treating dry eye diseases, phototherapy has attracted great attention, but the research on its safety and effectiveness is limited. In this study, the therapeutic effects of low-color-temperature light-emitting diodes on dry eye in humans, rabbits, and rats were investigated. METHODS: In clinical experiments, subjects in both groups read the same paper for 3 h under light sources of two color temperatures: 1900 K (low-color-temperature light-emitting diodes) or 4000 K (artificial fluorescent white light-emitting diodes). The differences in the non-invasive tear film breakup time, tear meniscus height, and conjunctival congestion scores before and after the experiment were compared between the two groups. In animal experiments, corneal epithelial barrier function and tear production of Sprague-Dawley rats and New Zealand white rabbits with dry eye were compared before and after low-color-temperature light-emitting diodes treatment. TUNEL staining and Western blotting were used to detect the apoptosis of corneal and conjunctival cells and the expression of inflammatory factor IL-1ß. RESULTS: Low-color-temperature light-emitting diodes prolonged tear film breakup time in patients with dry eye. Moreover, it increased tear secretion, decreased fluorescein sodium staining scores, corneal and conjunctival cell apoptosis, and inflammatory factor expression in rabbits and rats with dry eye. CONCLUSIONS: Low-color-temperature light-emitting diodes phototherapy can be used as an effective treatment for dry eye, reducing its symptoms and related ocular surface damage in humans, rabbits, and rats.

Tear Film Lipid Layer Changes Following Combined Effect of Heated Eye Mask with Intense Pulsed Light Therapy for Evaporative Dry Eye: A Randomized Control Study.

Background: Dry eye disease (DED) is a complex ocular surface inflammatory disorder with a multifactorial etiology. Therapies such as intense pulsed light (IPL) and heated eye mask (HEM) have been reported to improve the tear film lipid layer (TFLL) and signs and symptoms of DED. Methods: This randomized study aimed to compare the effects of IPL combined with HEM (IPL+HEM) group, IPL group, and control group in participants with evaporative DED. All participants were examined at baseline (D0), day 21 (D21), day 42 (D42), and day 84 (D84) for noninvasive tear breakup time (NITBUT), TFLL, corneal conjunctival staining (CS), meibomian gland quality (MGQ), meibomian gland expressibility (MGEx), and Ocular Surface Disease Index (OSDI). Results: The mean age of participants was IPL+HEM: 28.06 ± 3.88 years, IPL: 29.88 ± 4.68 years, and control: 28.52 ± 3.77 years. At D84, significant improvements in TFLL (p < 0.05), noninvasive tear breakup time (NITBUT) (p < 0.05), corneoconjunctival staining (CS) (p < 0.05), MGQ (p < 0.05), MGEx (p < 0.05), and OSDI (p < 0.05) were found in the IPL+HEM and IPL groups, whereas the control group had no significant improvements. Furthermore, ΔTFLL significantly correlated with ΔNITBUT (r = -0.678, p < 0.001), ΔCS (r = 0.321, p < 0.001), ΔMGQ (r = 0.669, p < 0.001), ΔMGEx (r = 0.598, p < 0.001), and ΔOSDI score (r = 0.649, p < 0.001). Conclusions: IPL therapy in combination with HEM and IPL therapy only can significantly improve the quality of TFLL and clinically reduce the sign and symptoms of evaporative DED. However, IPL therapy in combination with HEM was found to be more effective than IPL therapy alone.

Subjective Quality of Vision in Evaporative Dry Eye Patients After Intense Pulsed Light.

Background and objective: Intense pulsed light (IPL) improves visual and clinical symptoms of dry eye disease and helps improve meibomian gland (MG) function thereby positively contributing to the tear lipid layer, a major component for a normal tear film physiology. The objective of this study was to assess the effectiveness of IPL in moderate to severe evaporative dry eye (DE) owing to meibomian gland dysfunction (MGD) on the subjective quality of vision (QOV). Methods: This is a prospective, open-label study; patients with moderate to severe evaporative DE owing to MGD were consecutively enrolled and underwent two IPL treatment sessions at 3-week intervals. Clinical assessments included: Ocular Surface Disease Index (OSDI) and QOV questionnaires, noninvasive tear breakup time (NITBUT), interferometric fringe pattern as determined by tear film lipid layer (TFLL) quality, lid margin abnormalities, corneal fluorescein staining (CFS), conjunctival hyperemia (CH) redness score, MG (evaluated with a slit-lamp microscope), best-corrected visual acuity, endothelial cell count, and intraocular pressure were conducted at pretreatment, days 21 and 42 after IPL treatment. Results: A total of 128 eyes of 64 patients (39 women, 25 men; mean age 36.09 ± 11.13 years) with moderate to severe DE owing to MGD consecutively received IPL treatment at days 1 and 21. OSDI (p < 0.05), QOV (p < 0.05), NITBUT (p < 0.05), TFLL score (p < 0.05), and MG quality and expressibility (p < 0.05) improved significantly at day 42, whereas CFS and CH showed minor not significant improvements (p > 0.05) at day 42 of assessment. Conclusions: IPL treatment reduced the severity of DE symptoms and improved the overall tear film stability in patients with moderate to severe evaporative DE owing to MGD. In addition, visual complaints experienced by DE patients secondary to MGD significantly decreased.

Intense Pulsed Light Applied Directly on Eyelids Combined with Meibomian Gland Expression to Treat Meibomian Gland Dysfunction.

OBJECTIVE: To determine the efficacy and safety of intense pulsed light (IPL) applied directly on the eyelids and meibomian gland expression (MGX) in treating meibomian gland dysfunction (MGD). BACKGROUND: IPL application on the periocular skin effectively improves meibomian gland secretion and tear film break-up time (TBUT) in patients with MGD/dry eye. METHODS: This prospective, randomized, double-masked, controlled study involved 44 patients. One eye was randomly selected for IPL treatment; the other served as a control. Study eyes received three IPL treatments at 4-week intervals; IPL was applied directly on the eyelids, and the eye was protected with a Jaeger lid plate. Control eyes received sham IPL treatments. Both eyes received MGX and artificial tears. Meibomian gland yielding secretion score (MGYSS), TBUT, Standard Patient Evaluation of Eye Dryness (SPEED), cornea fluorescein staining (CFS), meibography, best corrected visual acuity (BCVA), intraocular pressure (IOP), and fundus examination were performed. RESULTS: Compared to the baseline, MGYSS, TBUT, and SPEED and CFS scores improved in the study eyes, while only SPEED and CFS scores improved in the control eyes (p < 0.001 for all). Changes in MGYSS and TBUT were higher in the study eyes than in the control eyes (p < 0.05), but changes in SPEED and CFS scores were similar (p > 0.05). BCVA and IOP improved in both the study and control eyes (p < 0.05). Five patients experienced mild pain and burning during IPL treatment. One patient suffered partial eyelash loss. CONCLUSIONS: IPL combined with MGX safely and effectively treated MGD.