Luz pulsada intensa combinada con expresión de las glándulas de Meibomio para el tratamiento del chalación / Intense pulsed light combined with meibomian gland expression for chalazion management

Objetivo Investigar la eficacia y la seguridad del protocolo de luz pulsada intensa (IPL) combinando el protocolo de tratamiento con IPL para la disfunción de las glándulas de Meibomio/enfermedad de ojo seco con IPL aplicada directamente en los párpados, asociada a la expresión de las glándulas de Meibomio (GM) para el tratamiento del chalación. Material y métodos Estudio retrospectivo de serie de casos. Los pacientes que presentaron chalación, recibieron un tratamiento combinado de terapia con IPL que consistió en usar el protocolo habitual de IPL para disfunción de las glándulas de Meibomio/enfermedad de ojo seco empleando una fluencia de acuerdo al tipo de piel según Fitzpatrick, seguido de una segunda fase (en la misma sesión) de aplicación IPL directamente sobre los párpados de ambos ojos empleando una fluencia de 10J/cm2. A continuación, todos los pacientes recibieron expresión de las GM, higiene de los párpados, antibiótico tópico y medicación ocular antiinflamatoria tópica. Los efectos adversos relacionados con este protocolo se evaluaron en cada sesión de IPL. Resultados Se incluyeron 26 chalaciones de diecinueve pacientes (24 ojos) con una edad media de 49,89±20,43 años. Fueron necesarias 2,07±0,97 sesiones de IPL de media para la resolución del chalación. El tratamiento combinado de protocolo IPL y expresión de GM mostró un 96,15% de eficacia y no se observaron efectos adversos. Conclusiones El tratamiento combinado de IPL para disfunción de las glándulas de Meibomio/enfermedad de ojo seco con IPL aplicado directamente sobre los párpados y expresión de GM podría ser eficaz y seguro para el tratamiento de los chalaciones (AU)

Objective To investigate the efficacy and safety of an intense pulsed light (IPL) combined IPL treatment protocol for meibomian gland dysfunction (MGD)/dry eye disease (DED) with IPL applied directly to the eyelids, associated with meibomian gland (MG) expression for the treatment of chalazion. Material and Methods Retrospective case series study. Patients presenting with chalazion received a combined IPL therapy treatment consisting of using the usual IPL protocol for DGM/EOS using a fluence according to skin type according to Fitzpatrick, followed by a second phase (in the same session) of IPL application directly on the eyelids of both eyes using a fluence of 10 J/cm2. All patients then received GM expression, eyelid hygiene, topical antibiotic and topical ocular anti-inflammatory medication. Adverse effects related to this protocol were assessed at each IPL session. Results Twenty-six chalazions from nineteen patients (24 eyes) with a mean age of 49.89 ± 20.43 years were included. An average of 2.07 ± 0.97 IPL sessions were required for chalazion resolution. The combined treatment of IPL protocol and GM expression showed 96.15% efficacy and no adverse effects were observed. Conclusions Combined IPL treatment for DGM/EOS with IPL applied directly on the eyelids and GM expression could be effective and safe for the treatment of chalazions (AU)

Los hallazgos oculares relacionados con el uso de bisfosfonatos orales / The ocular findings related to oral bisphosphonate use

Objetivo Nuestro objetivo fue investigar los hallazgos de afectación ocular en pacientes femeninas con osteoporosis que usaban bisfosfonato oral (BP). Métodos Se incluyó en el estudio a un total de 51 pacientes con osteoporosis, de 50 a 75 años, que utilizaron BP oral durante al menos un año para el grupo de estudio y a 64 pacientes sin osteoporosis de la misma edad para el grupo de control, todas del sexo femenino. Se anotaron el tipo de BP y el tiempo de exposición. Se evaluaron los resultados del examen oftálmico de las pacientes que recibieron BP oral por osteoporosis y de las controles. Resultados La duración media del uso de BP fue de 3,96 años. Se detectó que 4de 51 pacientes fueron diagnosticadas con disfunción de la glándula de Meibomio (7,8%), 7de 102 ojos tenían margen palpebral eritematoso, irregular, engrosado o telangiectasia alrededor de los orificios glandulares. No hubo hallazgos patológicos en el examen del fondo de ojo. El valor medio de las medidas del brote (ph/ms) fue de 7,90±7,96 en el grupo de estudio y de 5,02±0,81 en el grupo de control. Cuando se compararon los valores medios, hubo una diferencia significativa entre los 2grupos (p=0,001). Se encontró una diferencia significativa en el valor medio de las mediciones del flare entre las pacientes que usaban alendronato e ibandronato y las del grupo de control (p=0,001; p=0,005, respectivamente). Conclusión Nuestro estudio mostró que el flare de la cámara anterior asociado con la inflamación crónica del ojo se puede observar con mayor frecuencia en pacientes que usan alendronato e ibandronato por vía oral en comparación con aquellos que no lo hacen. Además, se puede decir que BP oral puede provocar efectos secundarios oculares similares a los de la BP intravascular (AU)

Objective We aimed to investigate ocular involvement findings in female osteoporosis patients using oral bisphosphonate (BP). Methods A total of 51 female osteoporosis patients aged 50-75 years using oral BP for at least one year for the study group and 64 age-matched non-osteoporosis female patients for the control group were included in the study. The BP type and exposure time were noted. The ophthalmic examination findings and measurements of the flare of the patients who received oral BP due to osteoporosis and the controls were evaluated. Results The mean duration of BP use was 3.96 years. In the study group, it was detected 4of 51 patients were diagnosed with meibomian gland dysfunction (MGD) (7.8%), 7of 102 eyes had erythematous, irregular, thickened lid margin or telangiectasia around the glandular orifices. There were no pathological findings on fondus examination. The mean value of measurements of the flare (ph/ms) was 7.90±7.96 in the study group, and 5.02±0.81 in the control group. When the mean values were compared, there was a significant difference between the 2groups (P=0.001). A significant difference was found in the mean value of measurements of the flare between the patients using alendronate, and ibandronate with the control group (P=0.001; P=0.005, respectively). Conclusion Our study showed that the flare in the anterior chamber associated with chronic ocular inflammation can be seen higher rate in patients using oral alendronate, and ibandronate compared to those who do not. Morever it can be said that oral BPs may cause similar ocular side effects like as intravascular BPs (AU)

Intense pulsed light combined with meibomian gland expression for chalazion management.

OBJECTIVE: To investigate the efficacy and safety of an intense pulsed light (IPL) combined IPL treatment protocol for meibomian gland dysfunction (MGD)/dry eye disease (DED) with IPL applied directly to the eyelids, associated with meibomian gland (MG) expression for the treatment of chalazion. MATERIAL AND METHODS: Retrospective case series study. Patients presenting with chalazion received a combined IPL therapy treatment consisting of using the usual IPL protocol for DGM/EOS using a fluence according to skin type according to Fitzpatrick, followed by a second phase (in the same session) of IPL application directly on the eyelids of both eyes using a fluence of 10J/cm2. All patients then received GM expression, eyelid hygiene, topical antibiotic and topical ocular anti-inflammatory medication. Adverse effects related to this protocol were assessed at each IPL session. RESULTS: Twenty-six chalazions from nineteen patients (24 eyes) with a mean age of 49.89±20.43 years were included. An average of 2.07±0.97 IPL sessions were required for chalazion resolution. The combined treatment of IPL protocol and GM expression showed 96.15% efficacy and no adverse effects were observed. CONCLUSIONS: Combined IPL treatment for MGD/DED with IPL applied directly onto the eyelids and MGX could be effective and safe for the management of chalazions.

Correlation between type 2 diabetes, dry eye and Meibomian glands dysfunction.

PURPOSE: To assess the Meibomian glands, ocular surface and tear function in patients with type 2 diabetes, and study the correlation between these conditions. METHODS: Prospective study of 76 males, 37 with type 2 diabetes with an average of duration between 7±5 years, and 36 males from control group. After completing an ocular surface disease index (OSDI) questionnaire, the non-invasive tear film break-up time (NIBUT) and the tear lipid layer pattern was performed using interferometry system and tear meniscus height/TMH. Ocular surface was studied with lissamine green staining and morphology of the glands with evaluation of Marx's line (lid margin abnormalities); meibomian secretion was expressed and was also assessed the quality. The results were analyzed using the statistical Kruskal-Wallis and Mann-Whitney, and correlations by Spearman Rho. RESULTS: The mean age was 59±8 years; 71% of participants presented MGD (76% diabetics and 67% controls). OSDI were significantly higher (p=0.01) in the diabetic group. A positive correlation was found between glycemia and symptoms (p=0.0005) and strong correlation between Hb1Ac and OSDI in MGD. NIBUT was lower in the control group (2.47±1.2s) than for the diabetic group (2.9±1.2s), with a significant inverse correlation (52.22%) with MG inflammation. CONCLUSIONS: MGD in type 2 diabetic patients is more severe compared with nondiabetic patients. Longer duration of diabetes is associated with major symptoms and changes in MG. Diabetic group showed major changes in lids and tear function, accounting for evaporative dry eye and presenting a high degree of correlation with MG inflammation and obstruction.