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    Treating dry eye with intense pulsed light

    San Diego—Patients with evaporative dry eye produce an abnormal meibum that is more viscous than patients with normal meibum, said Gargi K. Vora, MD.

    Severe inflammation and bacterial overgrowth can exacerbate the problem, added Dr. Vora, who is in practice in Durham, NC.

    Anti-inflammatory drops, warm compresses, and even lid expression have been marginally effective, but intense pulsed light (IPL) may be a viable option.

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    Dr. Vora conducted a retrospective chart review of 100 patients with a diagnosis of meibomian gland dysfunction (MGD) and dry eye syndrome that underwent IPL therapy from September 2012 to August 2014 at two outpatient eye centers (one at Duke and one at a private practice in Pennsylvania and New Jersey).

    IPL has been used in dermatology practices as a rosacea treatment for years, but “is a relatively new treatment for MGD and evaporative dry eye,” she said, although it has been used for inflammatory lid disease.

    Some studies by Toyos et al. have hyptothesized that IPL treatment near the lid would cause the abnormal blood vessels to close and noted the effect seemed to be positive on patients with MGD. (Rolando Toyos, MD, is credited as far back as 2002 with discovering the potential use of IPL in ocular indications.)

    Dr. Vora’s group evaluated numerous dry eye parameters, including the ocular surface disease index (OSDI), tear break-up time (TBUT), eyelid and facial vascularity, eyelid margin edema, and meibomian gland oil flow and quality.

    They used the Dermamed Quadra 4 IPL with its proprietary dry eye mode, and used Fitzpatrick scale to determine the energy parameters, Dr. Vora said.

    The laser uses a xenon flashlight in a band between 400 and 1,300 nm.

    Next: Study results

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