Toyos Rolando, Toyos Melissa, Willcox Jennifer, Mulliniks Haylie, Hoover James
Department of Opthalmology, Toyos Clinic, Germantown, Tennessee.
Department of Opthalmology, Toyos Clinic, Nashville, Tennessee.
Photobiomodul Photomed Laser Surg. 2019 Sep;37(9):527-531. doi: 10.1089/photob.2018.4599. Epub 2019 Jul 29.
To investigate the safety of and change from baseline of tear breakup time and visual analog pain scales in dry eye disease subjects with upper lid Meibomian gland dysfunction after intense pulsed light (IPL) treatment assessing global ocular pain severity, ocular pain frequency, and ocular pain in the previous 24 h. This is a prospective single-site study. All patients received active treatment consisting of four treatments spaced no fewer than 2 weeks apart and no longer than 4 weeks apart. The IPL therapy was performed with a Lumenis M22 (Lumenis Ltd., Yokneam, Israel) xenon-based micropulsed IPL utilizing a 590 nm filter with a 6 mm clear SapphireCool cylindrical lightguide for the upper lids with a fluence of 10 J/cm across the upper eyelids, including the tragus for two passes. Patients then received expression of their meibomian glands using two cotton-tipped applicators. Tear breakup data were collected as well as global ocular pain, ocular pain episodes in the past 24 h and frequency of ocular pain episodes. All of the assessments for the treated eyes improved over the course of treatment. Statistically significant physician increases in measured tear breakup times were measured for each eye independently. Statistically significant decreases in global eye dryness scale, eye dryness in the preceding 24 h, and frequency of ocular pain episodes between treatments were observed. There were no serious or nonserious adverse events in the trial. This pilot study suggests that a new specialized 6 mm cylindrical handpiece for the M22 Lumenis IPL machine is safe and effective in increasing physician-measured tear breakup time as well as several scales of the symptoms of ocular dryness, including global symptoms, frequency of symptoms, and ocular dryness occurring within the previous 24 h before the study visit.
为了研究患有上睑睑板腺功能障碍的干眼疾病受试者在接受强脉冲光（IPL）治疗后泪膜破裂时间和视觉模拟疼痛量表相对于基线的安全性变化，评估整体眼部疼痛严重程度、眼部疼痛频率以及过去24小时内的眼部疼痛情况。这是一项前瞻性单中心研究。所有患者均接受积极治疗，包括四次治疗，每次治疗间隔不少于2周且不超过4周。IPL治疗使用Lumenis M22（Lumenis有限公司，以色列约克奈姆）基于氙气的微脉冲IPL，采用590nm滤光片和6mm透明蓝宝石冷却圆柱形光导用于上睑，在上眼睑包括耳屏进行两次照射，能量密度为10J/cm²。然后使用两个棉签对患者的睑板腺进行挤压。收集泪膜破裂数据以及整体眼部疼痛、过去24小时内的眼部疼痛发作情况和眼部疼痛发作频率。在治疗过程中，对治疗眼的所有评估指标均有所改善。分别独立测量每只眼睛的泪膜破裂时间，医生测量值有统计学意义的增加。观察到治疗之间整体眼干量表、前24小时眼干情况以及眼部疼痛发作频率有统计学意义的下降。试验中未出现严重或非严重不良事件。这项初步研究表明，Lumenis IPL M22机器的新型专用6mm圆柱形手持探头在增加医生测量的泪膜破裂时间以及多种眼部干燥症状量表方面是安全有效的，这些症状量表包括整体症状、症状频率以及在研究就诊前24小时内出现的眼部干燥情况。
