Skip to main content
Top
Published in: BMC Ophthalmology 1/2022

Open Access 01-12-2022 | Intense Pulsed Light | Research

A retrospective study of the efficacy of intense pulsed light delivered by the Lacrystim® for meibomian gland dysfunction therapy

Authors: Marie-Caroline Trone, Thibaud Garcin, Edouard Ollier, Gilles Thuret, Philippe Gain

Published in: BMC Ophthalmology | Issue 1/2022

Login to get access

Abstract

Background

Meibomian gland dysfunction is the most common etiology of dry eye disease worldwide and intense pulsed light appears to be a promising treatment with encouraging results. Lacrystim® is a new IPL device (CE marking in 2019) and no studies have yet been published on it. We propose the first study on this device with an objective assessment of its efficacy and an extended follow-up over 6 months.

Methods

Patients presenting with a dry eye disease (DED) with stable mild to moderate MGD and having received Lacrystim® treatment between june 2019 and june 2020 were included. 3 IPL sessions were performed at D0, D15 and D45 with 4 shots per side at a fluence of 8 mJ/cm2. DED clinical evaluation was performed at D0, D15, D45, 3rd month and 6th month: Oxford scale and break up time, Schirmer test and Ocular Surface Disease Index (OSDI) questionnaire. Lacrydiag® imaging device carried out an objective examination of tear film: interferometry, meibography, tear meniscus height and non-invasive break up time (NIBUT). The primary endpoint was the evolution in NIBUT between the first visit D0 and 3rd month. Data collection was done retrospectively. Statistical analysis was done using a linear mixed-effects model and a non-parametric linear mixed-effects model (R software).

Results

Forthy five consecutive patients were included. NIBUT significantly increased between D0 and 3rd month: mean difference of 1.63 seconds, IC95% [0.51; 2.62], (p = 0.002) with a prolonged effect at 6th month. OSDI and OXFORD scores and interferometry were also significantly improved at 3rd month and 6th month. There was no significant change in BUT, Schirmer test and tear meniscus height. No adverse event was noted.

Conclusions

IPL delivered by Lacrystim® appears effective and safe to treat MGD although a randomized controlled trial is needed to validate its results.

Trial registration

This work was approved by a local ethics committee “Terre d’éthique” (institutional review board number: IRBN672019/CHUSTE) and registered on the clinicaltrial.​gov website (NCT04147962, 01/11/2019).
Literature
1.
go back to reference Asbell PA, Stapleton FJ, Wickström K, Akpek EK, Aragona P, Dana R, et al. The international workshop on meibomian gland dysfunction: report of the clinical trials subcommittee. Invest Ophthalmol Vis Sci. mars. 2011;52(4):2065–85.CrossRef Asbell PA, Stapleton FJ, Wickström K, Akpek EK, Aragona P, Dana R, et al. The international workshop on meibomian gland dysfunction: report of the clinical trials subcommittee. Invest Ophthalmol Vis Sci. mars. 2011;52(4):2065–85.CrossRef
2.
go back to reference Bron AJ, de Paiva CS, Chauhan SK, Bonini S, Gabison EE, Jain S, et al. TFOS DEWS II pathophysiology report. Ocul Surf. 2017;15(3):438–510.CrossRef Bron AJ, de Paiva CS, Chauhan SK, Bonini S, Gabison EE, Jain S, et al. TFOS DEWS II pathophysiology report. Ocul Surf. 2017;15(3):438–510.CrossRef
3.
go back to reference Arita R, Mizoguchi T, Kawashima M, Fukuoka S, Koh S, Shirakawa R, et al. Meibomian gland dysfunction and dry eye are similar but different based on a population-based study: the Hirado-Takushima study in Japan. Am J Ophthalmol. 2019;207:410–8.CrossRef Arita R, Mizoguchi T, Kawashima M, Fukuoka S, Koh S, Shirakawa R, et al. Meibomian gland dysfunction and dry eye are similar but different based on a population-based study: the Hirado-Takushima study in Japan. Am J Ophthalmol. 2019;207:410–8.CrossRef
4.
go back to reference Sabeti S, Kheirkhah A, Yin J, Dana R. Management of meibomian gland dysfunction: a review. Surv Ophthalmol avr. 2020;65(2):205–17.CrossRef Sabeti S, Kheirkhah A, Yin J, Dana R. Management of meibomian gland dysfunction: a review. Surv Ophthalmol avr. 2020;65(2):205–17.CrossRef
5.
go back to reference Husain Z, Alster TS. The role of lasers and intense pulsed light technology in dermatology. Clin Cosmet Investig Dermatol. 2016;9:29–40.PubMedPubMedCentral Husain Z, Alster TS. The role of lasers and intense pulsed light technology in dermatology. Clin Cosmet Investig Dermatol. 2016;9:29–40.PubMedPubMedCentral
6.
go back to reference Paasch U, Schwandt A, Seeber N, Kautz G, Grunewald S, Haedersdal M. New lasers and light sources - old and new risks? J Dtsch Dermatol Ges J Ger Soc Dermatol JDDG mai 2017;15(5):487–496. Paasch U, Schwandt A, Seeber N, Kautz G, Grunewald S, Haedersdal M. New lasers and light sources - old and new risks? J Dtsch Dermatol Ges J Ger Soc Dermatol JDDG mai 2017;15(5):487–496.
7.
go back to reference Jones L, Downie LE, Korb D, Benitez-Del-Castillo JM, Dana R, Deng SX, et al. TFOS DEWS II management and therapy report. Ocul Surf. 2017;15(3):575–628.CrossRef Jones L, Downie LE, Korb D, Benitez-Del-Castillo JM, Dana R, Deng SX, et al. TFOS DEWS II management and therapy report. Ocul Surf. 2017;15(3):575–628.CrossRef
8.
go back to reference Liu R, Rong B, Tu P, Tang Y, Song W, Toyos R, et al. Analysis of cytokine levels in tears and clinical correlations after intense pulsed light treating Meibomian gland dysfunction. Am J Ophthalmol nov 2017;183:81–90. Liu R, Rong B, Tu P, Tang Y, Song W, Toyos R, et al. Analysis of cytokine levels in tears and clinical correlations after intense pulsed light treating Meibomian gland dysfunction. Am J Ophthalmol nov 2017;183:81–90.
9.
go back to reference Suwal A, Hao JL, Zhou DD, Liu XF, Suwal R, Lu CW. Use of intense pulsed light to mitigate Meibomian gland dysfunction for dry eye disease. Int J Med Sci. 2020;17(10):1385–92.CrossRef Suwal A, Hao JL, Zhou DD, Liu XF, Suwal R, Lu CW. Use of intense pulsed light to mitigate Meibomian gland dysfunction for dry eye disease. Int J Med Sci. 2020;17(10):1385–92.CrossRef
10.
go back to reference Tashbayev B, Yazdani M, Arita R, Fineide F, Utheim TP. Intense pulsed light treatment in meibomian gland dysfunction: A concise review. Ocul Surf. 3 juill 2020; Tashbayev B, Yazdani M, Arita R, Fineide F, Utheim TP. Intense pulsed light treatment in meibomian gland dysfunction: A concise review. Ocul Surf. 3 juill 2020;
11.
go back to reference Dell SJ. Intense pulsed light for evaporative dry eye disease. Clin Ophthalmol Auckl NZ. 2017;11:1167–73.CrossRef Dell SJ. Intense pulsed light for evaporative dry eye disease. Clin Ophthalmol Auckl NZ. 2017;11:1167–73.CrossRef
12.
go back to reference Lam PY, Shih KC, Fong PY, Chan TCY, Ng ALK, Jhanji V, et al. A review on evidence-based treatments for Meibomian gland dysfunction. Eye Contact Lens janv. 2020;46(1):3–16.CrossRef Lam PY, Shih KC, Fong PY, Chan TCY, Ng ALK, Jhanji V, et al. A review on evidence-based treatments for Meibomian gland dysfunction. Eye Contact Lens janv. 2020;46(1):3–16.CrossRef
13.
go back to reference Fishman HA, Periman LM, Shah AA. Real-Time Video Microscopy of In Vitro Demodex Death by Intense Pulsed Light. Photobiomodulation Photomed Laser Surg. 27 janv 2020; Fishman HA, Periman LM, Shah AA. Real-Time Video Microscopy of In Vitro Demodex Death by Intense Pulsed Light. Photobiomodulation Photomed Laser Surg. 27 janv 2020;
14.
go back to reference Wolffsohn JS, Arita R, Chalmers R, Djalilian A, Dogru M, Dumbleton K, et al. TFOS DEWS II diagnostic methodology report. Ocul Surf. 2017;15(3):539–74.CrossRef Wolffsohn JS, Arita R, Chalmers R, Djalilian A, Dogru M, Dumbleton K, et al. TFOS DEWS II diagnostic methodology report. Ocul Surf. 2017;15(3):539–74.CrossRef
15.
go back to reference Tomlinson A, Bron AJ, Korb DR, Amano S, Paugh JR, Pearce EI, et al. The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee. Invest Ophthalmol Vis Sci mars. 2011;52(4):2006–49.CrossRef Tomlinson A, Bron AJ, Korb DR, Amano S, Paugh JR, Pearce EI, et al. The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee. Invest Ophthalmol Vis Sci mars. 2011;52(4):2006–49.CrossRef
16.
go back to reference Remeseiro B, Bolon-Canedo V, Peteiro-Barral D, Alonso-Betanzos A, Guijarro-Berdiñas B, Mosquera A, et al. A methodology for improving tear film lipid layer classification. IEEE J Biomed Health Inform juill. 2014;18(4):1485–93.CrossRef Remeseiro B, Bolon-Canedo V, Peteiro-Barral D, Alonso-Betanzos A, Guijarro-Berdiñas B, Mosquera A, et al. A methodology for improving tear film lipid layer classification. IEEE J Biomed Health Inform juill. 2014;18(4):1485–93.CrossRef
17.
go back to reference Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the ocular surface disease index. Arch Ophthalmol Chic Ill 1960. mai 2000;118(5):615–621. Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the ocular surface disease index. Arch Ophthalmol Chic Ill 1960. mai 2000;118(5):615–621.
18.
go back to reference Guillemin I, Begley C, Chalmers R, Baudouin C, Arnould B. Appraisal of patient-reported outcome instruments available for randomized clinical trials in dry eye: revisiting the standards. Ocul Surf avr. 2012;10(2):84–99.CrossRef Guillemin I, Begley C, Chalmers R, Baudouin C, Arnould B. Appraisal of patient-reported outcome instruments available for randomized clinical trials in dry eye: revisiting the standards. Ocul Surf avr. 2012;10(2):84–99.CrossRef
19.
go back to reference Noguchi K, GEL YR, Brunner E, et al. An R software package for the nonparametric analysis of longitudinal data in factorial experiments. J Stat Softw. 2012;50(12). Noguchi K, GEL YR, Brunner E, et al. An R software package for the nonparametric analysis of longitudinal data in factorial experiments. J Stat Softw. 2012;50(12).
20.
go back to reference Dessau RB, Pipper CB. [“R"--project for statistical computing]. Ugeskr Laeger. 28 janv 2008;170(5):328–30. Dessau RB, Pipper CB. [“R"--project for statistical computing]. Ugeskr Laeger. 28 janv 2008;170(5):328–30.
21.
go back to reference Wickham H. ggplot2. WIREs Comput Stat 4 févr 2011;3(2):180–185. Wickham H. ggplot2. WIREs Comput Stat 4 févr 2011;3(2):180–185.
22.
go back to reference Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol juin. 1988;124(6):869–71.CrossRef Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol juin. 1988;124(6):869–71.CrossRef
23.
go back to reference Jiang X, Lv H, Song H, Zhang M, Liu Y, Hu X, et al. Evaluation of the safety and effectiveness of intense pulsed light in the treatment of Meibomian gland dysfunction. J Ophthalmol. 2016;2016:1910694.PubMedPubMedCentral Jiang X, Lv H, Song H, Zhang M, Liu Y, Hu X, et al. Evaluation of the safety and effectiveness of intense pulsed light in the treatment of Meibomian gland dysfunction. J Ophthalmol. 2016;2016:1910694.PubMedPubMedCentral
24.
go back to reference Karaca EE, Evren Kemer Ö, Özek D. Intense regulated pulse light for the meibomian gland dysfunction. Eur J Ophthalmol mars. 2020;30(2):289–92.CrossRef Karaca EE, Evren Kemer Ö, Özek D. Intense regulated pulse light for the meibomian gland dysfunction. Eur J Ophthalmol mars. 2020;30(2):289–92.CrossRef
25.
go back to reference Arita R, Mizoguchi T, Fukuoka S, Morishige N. Multicenter study of intense pulsed light therapy for patients with refractory Meibomian gland dysfunction. Cornea déc. 2018;37(12):1566–71.CrossRef Arita R, Mizoguchi T, Fukuoka S, Morishige N. Multicenter study of intense pulsed light therapy for patients with refractory Meibomian gland dysfunction. Cornea déc. 2018;37(12):1566–71.CrossRef
26.
go back to reference Guilloto Caballero S, García Madrona JL, Colmenero RE. Effect of pulsed laser light in patients with dry eye syndrome. Arch Soc Espanola Oftalmol. 92(11):509–15. Guilloto Caballero S, García Madrona JL, Colmenero RE. Effect of pulsed laser light in patients with dry eye syndrome. Arch Soc Espanola Oftalmol. 92(11):509–15.
27.
go back to reference Toyos R, McGill W, Briscoe D. Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retrospective study. Photomed Laser Surg janv. 2015;33(1):41–6.CrossRef Toyos R, McGill W, Briscoe D. Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retrospective study. Photomed Laser Surg janv. 2015;33(1):41–6.CrossRef
28.
go back to reference Craig JP, Chen YH, Turnbull PRK. Prospective trial of intense pulsed light for the treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci. 12 févr 2015;56(3):1965–1970. Craig JP, Chen YH, Turnbull PRK. Prospective trial of intense pulsed light for the treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci. 12 févr 2015;56(3):1965–1970.
29.
go back to reference Wei S, Ren X, Wang Y, Chou Y, Li X. Therapeutic effect of intense pulsed light (IPL) combined with Meibomian gland expression (MGX) on Meibomian gland dysfunction (MGD). J Ophthalmol. 2020;2020:3684963.PubMedPubMedCentral Wei S, Ren X, Wang Y, Chou Y, Li X. Therapeutic effect of intense pulsed light (IPL) combined with Meibomian gland expression (MGX) on Meibomian gland dysfunction (MGD). J Ophthalmol. 2020;2020:3684963.PubMedPubMedCentral
30.
go back to reference Vegunta S, Patel D, Shen JF. Combination therapy of intense pulsed light therapy and Meibomian gland expression (IPL/MGX) can improve dry eye symptoms and Meibomian gland function in patients with refractory dry eye: a retrospective analysis. Cornea mars. 2016;35(3):318–22.CrossRef Vegunta S, Patel D, Shen JF. Combination therapy of intense pulsed light therapy and Meibomian gland expression (IPL/MGX) can improve dry eye symptoms and Meibomian gland function in patients with refractory dry eye: a retrospective analysis. Cornea mars. 2016;35(3):318–22.CrossRef
31.
go back to reference Arita R, Fukuoka S, Morishige N. Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction. Ocul Surf. 2019;17(1):104–10.CrossRef Arita R, Fukuoka S, Morishige N. Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction. Ocul Surf. 2019;17(1):104–10.CrossRef
32.
go back to reference Piyacomn Y, Kasetsuwan N, Reinprayoon U, Satitpitakul V, Tesapirat L. Efficacy and safety of intense pulsed light in patients with Meibomian gland dysfunction-a randomized, double-masked. Sham-Controlled Clinical Trial Cornea. 2020;39(3):325–32.PubMed Piyacomn Y, Kasetsuwan N, Reinprayoon U, Satitpitakul V, Tesapirat L. Efficacy and safety of intense pulsed light in patients with Meibomian gland dysfunction-a randomized, double-masked. Sham-Controlled Clinical Trial Cornea. 2020;39(3):325–32.PubMed
33.
go back to reference Jewsbury H, Morgan F. Uveitis and iris photoablation secondary to intense pulsed light therapy. Can J Ophthalmol J Can Ophtalmol août. 2012;47(4):e13–4.CrossRef Jewsbury H, Morgan F. Uveitis and iris photoablation secondary to intense pulsed light therapy. Can J Ophthalmol J Can Ophtalmol août. 2012;47(4):e13–4.CrossRef
34.
go back to reference Chang CY, Sheu SJ. Choroidal neovascularization secondary to intense pulsed light injury. Ophthal Plast Reconstr Surg. août. 2018;34(4):e129–31.CrossRef Chang CY, Sheu SJ. Choroidal neovascularization secondary to intense pulsed light injury. Ophthal Plast Reconstr Surg. août. 2018;34(4):e129–31.CrossRef
35.
go back to reference Lee WW, Murdock J, Albini TA, O’brien TP, Levine ML. Ocular damage secondary to intense pulse light therapy to the face. Ophthal Plast Reconstr Surg août. 2011;27(4):263–5.CrossRef Lee WW, Murdock J, Albini TA, O’brien TP, Levine ML. Ocular damage secondary to intense pulse light therapy to the face. Ophthal Plast Reconstr Surg août. 2011;27(4):263–5.CrossRef
36.
go back to reference Yan X, Hong J, Jin X, Chen W, Rong B, Feng Y, et al. The Efficacy of Intense Pulsed Light Combined With Meibomian Gland Expression for the Treatment of Dry Eye Disease Due to Meibomian Gland Dysfunction: A Multicenter, Randomized Controlled Trial. Eye Contact Lens. 19 mai 2020; Yan X, Hong J, Jin X, Chen W, Rong B, Feng Y, et al. The Efficacy of Intense Pulsed Light Combined With Meibomian Gland Expression for the Treatment of Dry Eye Disease Due to Meibomian Gland Dysfunction: A Multicenter, Randomized Controlled Trial. Eye Contact Lens. 19 mai 2020;
37.
go back to reference Li D, Lin SB, Cheng B. Intense pulsed light treatment for Meibomian gland dysfunction in skin types III/IV. Photobiomodulation Photomed Laser Surg févr. 2019;37(2):70–6.CrossRef Li D, Lin SB, Cheng B. Intense pulsed light treatment for Meibomian gland dysfunction in skin types III/IV. Photobiomodulation Photomed Laser Surg févr. 2019;37(2):70–6.CrossRef
38.
go back to reference Rennick S, Adcock L. Intense Pulsed Light Therapy for Meibomian Gland Dysfunction: A Review of Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2018 [cité 12 déc 2019]. (CADTH rapid response reports). Disponible sur: http://www.ncbi.nlm.nih.gov/books/NBK531789/ Rennick S, Adcock L. Intense Pulsed Light Therapy for Meibomian Gland Dysfunction: A Review of Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2018 [cité 12 déc 2019]. (CADTH rapid response reports). Disponible sur: http://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK531789/​
Metadata
Title
A retrospective study of the efficacy of intense pulsed light delivered by the Lacrystim® for meibomian gland dysfunction therapy
Authors
Marie-Caroline Trone
Thibaud Garcin
Edouard Ollier
Gilles Thuret
Philippe Gain
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2022
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-022-02531-7

Other articles of this Issue 1/2022

BMC Ophthalmology 1/2022 Go to the issue