Current application of intense pulsed light for the management of dry eye disease: A systematic review and meta-analysis.

This review explored intense pulsed light (IPL) as an alternative treatment for dry eye disease (DED) symptom relief by correcting tear-film homeostasis. A systematic search was performed in March 2022 on five databases (Medline, Embase, SCOPUS, ProQuest, and EBSCO). Studies were extracted for the following outcomes of interest: standard patient evaluation of eye dryness questionnaire (SPEED), ocular surface disease index (OSDI), tear break-up time (TBUT), and corneal fluorescein staining (CFS). All studies published up to March 2022 were reviewed. Cochrane risk of bias tool (RoB 2) was used to screen studies for risk of bias where appropriate. A meta-analysis was done to quantify any reported quantitative data. Thirteen studies were included in this study. A total of 931 individuals and 1454 numbers of eyes were reviewed in this meta-analysis. Among studies that explored and reported the effect of IPL in individuals with DED, TBUT and OSDI improved significantly post intervention, with a standardized mean difference (SMD) of 1.02 [95% CI 0.41-1.64] and 0.28 [95% CI 0.04-0.52], respectively. CFS and SPEED scores, however, showed no statistically significant difference, with an SMD of 0.22 [95% CI -0.19 to 0.64] and 0.28 [95% CI -0.11 to 0.66], respectively. In conclusion, current evidence indicates IPL as a possible adjunctive treatment in individuals with DED in an otherwise limited treatment option. Further studies through more extensive trials are needed to validate this finding and elucidate its mechanism.

Challenging Management of Neovascular Glaucoma to Achieve the Best Visual Outcome.

Neovascular glaucoma (NVG) resulting from ischemic insults caused by various diseases, such as proliferative diabetic retinopathy and central vein occlusion, remains a challenging situation. This case report aims to describe the complex management of NVG, resulting from diabetic retinopathy, to achieve the best visual outcome. A 47-year-old male presented with poor visual acuity of both eyes. His right eye was inoperable. Ahmed valve implantation with intraoperative intravitreal bevacizumab injection was performed in his left eye. Panretinal photocoagulation was performed serially after phacoemulsification. However, intraocular pressure was found to be raised, thus necessitating 5-fluorouracil needling bleb revision and administration of intracameral bevacizumab injection. During 15 months of follow-up we were able to achieve the best visual outcome possible in this patient. Comprehensive management of NVG should be implemented with a multidisciplinary approach.