Medicine
A subscription to JoVE is required to view this content.
You will only be able to see the first 2 minutes.
The JoVE video player is compatible with HTML5 and Adobe Flash. Older browsers that do not support HTML5 and the H.264 video codec will still use a Flash-based video player. We recommend downloading the newest version of Flash here, but we support all versions 10 and above.
If that doesn't help, please let us know.
Intense Pulsed Light for the Treatment of Dry Eye Owing to Meibomian Gland Dysfunction
Chapters
Summary April 1st, 2019
Dry eye disease is an increasingly common condition, which strongly impair patients' life quality. Recently, a new device employing intense pulsed light, specifically designed for the periocular area, has been shown to improve tear film stability and ocular discomfort symptoms in dry eye disease owing to meibomian gland dysfunction.
Transcript
Meibomian gland dysfunction is typically managed with chronic therapies which often provide only partial or short-term relief from dry eye symptoms. Intense regulated pulsed light device emits multiple polychromatic light pulses that heat the eyelid skin, stimulate the meibomian glands, and reduce the release of anti-inflammatory mediators and tear cytokines. Open the I.C.P.program by SBM Sistemi onto the computer connected to the device.
Input the patient's data and select the appropriate exam in the menu. Instruct the patient to put their chin and the forehead in the correct position on the slit lamp with the instrument to perform non-invasive BUT examination. After non-invasive BUT, lipid layer thickness is examined.
For meibomian gland loss assessment, select the meibomian gland exam. Use a cotton swab to gently evert the lower eyelid and acquire an infrared image of the inner part of the lower eyelid to obtain a good-quality image of the meibomian glands. Draw the margins of the eyelid area on the touch screen, and click to fill the area.
The system will automatically calculate the percentage of meibomian gland area in relation to the total area of the eyelid. For intense pulsed light treatment, seat the patient comfortably and press the start button on the control unit to activate the device. To select the treatment for meibomian gland dysfunction, press the appropriate button the LCD touchscreen and use the up and down arrows to select the desired treatment energy level.
Press tick to confirm the choice and press the six icons one by one to validate each of the six safety features. Press tick to confirm that the procedure is performed in total safety, then press tick again to start the device. When the device is ready for the treatment, place the eye protector over the patient's eyes and don safety glasses.
Apply an at least one centimeter thick layer of optical gel over the patient's skin under the lower eyelid from the edge of the nose up to the temple. Remove the device handpiece from the central unit, and gently place the handpiece head in direct contact with the skin of the area to be treated. Press the start button on the handpiece to emit a single treating intense pulsed light pulse, followed by four additional intense pulsed light pulses across the gel-treated area as close as possible to the lower eyelid margin.
After the last pulse has been applied, gently remove the optical gel from the treated skin area and place a warm compress over the eyelids of both eyes for two to three minutes. In this study, 19 patients underwent intense pulsed light. Fifteen days after the third treatment session, non-invasive breakup times significantly increased, and the lipid layer thickness grade significantly improved.
No statistically significant changes were observed for meibomian gland loss, while tear osmolarity showed a trend of decrease after treatment. Seventeen patients demonstrated an improvement in ocular discomfort symptoms after the treatment, in direct correlation with the improved lipid layer thickness results in response to the intense pulsed light treatment. Intense regulated pulsed light treatment appears effective in improving dry eye sign and symptoms in patients affected by meibomian gland dysfunction.
Regular repeated treatments every six-eight months may be required after the three starting sessions to maintain the benefits of the procedure over the time.
Related Videos
You might already have access to this content!
Please enter your Institution or Company email below to check.
has access to
Please create a free JoVE account to get access
Login to access JoVE
Please login to your JoVE account to get access
We use/store this info to ensure you have proper access and that your account is secure. We may use this info to send you notifications about your account, your institutional access, and/or other related products. To learn more about our GDPR policies click here.
If you want more info regarding data storage, please contact gdpr@jove.com.
Please enter your email address so we may send you a link to reset your password.
We use/store this info to ensure you have proper access and that your account is secure. We may use this info to send you notifications about your account, your institutional access, and/or other related products. To learn more about our GDPR policies click here.
If you want more info regarding data storage, please contact gdpr@jove.com.
Your JoVE Unlimited Free Trial
Fill the form to request your free trial.
We use/store this info to ensure you have proper access and that your account is secure. We may use this info to send you notifications about your account, your institutional access, and/or other related products. To learn more about our GDPR policies click here.
If you want more info regarding data storage, please contact gdpr@jove.com.
Thank You!
A JoVE representative will be in touch with you shortly.
Thank You!
You have already requested a trial and a JoVE representative will be in touch with you shortly. If you need immediate assistance, please email us at subscriptions@jove.com.
Thank You!
Please enjoy a free 2-hour trial. In order to begin, please login.
Thank You!
You have unlocked a 2-hour free trial now. All JoVE videos and articles can be accessed for free.
To get started, a verification email has been sent to email@institution.com. Please follow the link in the email to activate your free trial account. If you do not see the message in your inbox, please check your "Spam" folder.
