Egri S, Van Hollebecke I, Guindolet D, Manenti C, Rougier H, Gabison É, Cochereau I, Doan S
Service d'Ophtalmologie, Fondation Adolphe-de-Rothschild, Paris, France.
Service d'Ophtalmologie, Fondation Adolphe-de-Rothschild, Paris, France.
J Fr Ophtalmol. 2021 Feb;44(2):169-175. doi: 10.1016/j.jfo.2020.04.061. Epub 2021 Jan 6.
Dry eye syndrome caused by Meibomian gland dysfunction (MGD) is a common disease in the general population and impairs quality of life. Intense Pulsed Light (IPL) has mainly been used in dermatology for the treatment of skin disorders, and more recently for MGD-related dry eye. The objective of our study is to evaluate the efficacy and tolerability of IPL with the E-Eye® device (E-Swin, Houdan, France) in severe MGD-related dry eye patients.
This non-comparative study included 20 patients with MGD-related dry eye with a Break-Up Time (BUT)<10seconds, dry eye symptoms >30mm on a Visual Analog Scale (VAS), and failure of lid hygiene and artificial tears. Treatment consisted of 3 sessions of IPL on D0, D15, and D45 (5 flashes of 13J/cm per eye). The following parameters were assessed at each visit and at D75 : symptoms graded with a VAS and the Standard Patient Assessment of Eye Dryness questionnaire (SPEED), BUT, corneal fluorescein staining, Meibomian gland expression score, meibography, tear film lipid layer thickness by interferometry and the ocular scattering index by double-pass aberrometry (OQAS). Statistical analysis was performed on the eye most affected at baseline.
We included 40 eyes of 20 patients, 15 female and 5 male, mean age 47±15 years (24 to 74 years). The symptoms rated by VAS were severe, averaging 69±25mm. After treatment, there was a statistically significant decrease in symptoms, with a 14mm VAS decrease (55±29mm at D75 versus 69mm at D0, P=0.048) and SPEED score of 3.4 (19.0±6mm versus 22.4±4.6, P=0.03). The number of expressible Meibomian gland ducts increased significantly (from 5.9 to 8.1, P=0.04), lid redness decreased (from 1.4 to 0.6, P=NS) and BUT improved (from 4.2 to 5.9, P=NS). Other parameters remained unchanged. Three patients (15%) complained of transient ocular burning after each treatment.
IPL appears to be effective in improving signs and symptoms in patients with severe MGD-related dry eye, with a good safety profile. Its exact mechanism of action remains to be elucidated.
睑板腺功能障碍（MGD）引起的干眼综合征在普通人群中是一种常见疾病，会损害生活质量。强脉冲光（IPL）主要用于皮肤科治疗皮肤疾病，最近也用于与MGD相关的干眼治疗。我们研究的目的是评估使用E-Eye®设备（E-Swin，法国乌丹）的IPL对重度MGD相关干眼患者的疗效和耐受性。
这项非对照研究纳入了20例MGD相关干眼患者，其泪膜破裂时间（BUT）<10秒，干眼症状在视觉模拟量表（VAS）上>30mm，且睑缘清洁和人工泪液治疗无效。治疗包括在第0天、第15天和第45天进行3次IPL治疗（每只眼睛5次13J/cm的闪光）。在每次就诊时以及第75天时评估以下参数：用VAS分级的症状、干眼标准患者评估问卷（SPEED）、BUT、角膜荧光素染色、睑板腺排出评分、睑板腺造影、通过干涉测量法测量的泪膜脂质层厚度以及通过双程像差仪测量的眼散射指数（OQAS）。对基线时受影响最严重眼睛的数据进行统计分析。
我们纳入了20例患者的40只眼睛，其中女性15例，男性5例，平均年龄47±15岁（24至74岁）。VAS评分的症状严重，平均为69±25mm。治疗后，症状有统计学意义的减轻，VAS降低了14mm（第75天时为55±29mm，第0天时为69mm，P = 0.048），SPEED评分为3.4（分别为19.0±6mm和22.4±4.6，P = 0.03）。可排出睑板腺导管的数量显著增加（从5.9增加到8.1，P = 0.04），睑缘发红减轻（从1.4降至0.6，P =无统计学意义），BUT改善（从4.2升至5.9，P =无统计学意义）。其他参数保持不变。3例患者（15%）每次治疗后均抱怨有短暂的眼部烧灼感。
IPL似乎对改善重度MGD相关干眼患者的体征和症状有效，且安全性良好。其确切作用机制仍有待阐明。
