Zhang Hongda, Qi Yifan, Chen Jiayan, Qin Guanghao, Xu Ling, He Wei, Yu Sile, Che Huixin, Pazo Emmanuel Eric
Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, Liaoning, People's Republic of China.
School of Public Health, He University, Shenyang, Liaoning, People's Republic of China.
Clin Ophthalmol. 2024 Jul 15;18:2061-2072. doi: 10.2147/OPTH.S471426. eCollection 2024.
The objective of this study was to assess the effectiveness of intense pulsed light (IPL) therapy in individuals diagnosed with glaucoma and dry eye disease (DED).
This randomized control study recruited 22 individuals diagnosed with glaucoma, ranging in age from 33 to 82 years. These participants were undergoing treatment with hypotensive eyedrops and had clinical indications and subjective complaints associated with dry eye. Each patient underwent three sessions of IPL therapy in one eye, while the contralateral eye served as the control eye (CT). The following parameters were assessed at three time points: baseline, week-2, and week-4. These parameters include non-invasive breakup time (NITBUT), tear meniscus height (TMH), conjunctivocorneal epithelial staining score (CS), tear film lipid layer (TFLL), meibomian gland expressibility score (MGEx), Schirmer I test, ocular bulbar redness score (OBRS), and ocular surface disease index (OSDI). Intraocular pressure (IOP), best-corrected visual acuity (BCVA), and corneal endothelial cell count (ECC) were assessed for safety. The clinical trial was registered on 25/12/2023 at ClinicalTrials.gov website (NCT06158984).
Comparing baseline and 4-week measurements revealed that the IPL group found significant improvements in NITBUT (IPL: 8.74±2.60 sec. vs CT: 5.76±1.75 sec. <0.01), TMH (IPL: 0.23±0.05mm vs CT: 0.19±0.06mm, =0.011), C.S. (IPL: 1.14±0.56 vs CT: 1.95±1.17, =0.005), TFLL (IPL: 2.91±2.91 vs CT:3.36±0.58, =0.047), MGEx score (IPL: 1.14±0.35 vs CT: 1.45±0.51, =0.020) and OSDI scores (IPL: 31.77±15.59 vs 50.59±21.55, =0.002) significantly improved. Conversely, other parameters showed no significant improvements (>0.05).
The progression of ocular surface disease in individuals using topical anti-glaucoma medication may worsen if the condition is not addressed. Nevertheless, IPL therapy has the potential to result in significant improvements in both objective and subjective measures of dry eye. Best-corrected visual acuity, endothelial cell count, and intraocular pressure were determined to be within the permitted limits. No adverse events were reported during the course of the study.
本研究的目的是评估强脉冲光（IPL）疗法对被诊断为青光眼和干眼症（DED）患者的有效性。
这项随机对照研究招募了22名被诊断为青光眼的患者，年龄在33至82岁之间。这些参与者正在接受降眼压眼药水治疗，并有与干眼症相关的临床指征和主观症状。每位患者一只眼睛接受三次IPL治疗，而对侧眼睛作为对照眼（CT）。在三个时间点评估以下参数：基线、第2周和第4周。这些参数包括非侵入性泪膜破裂时间（NITBUT）、泪河高度（TMH）、结膜角膜上皮染色评分（CS）、泪膜脂质层（TFLL）、睑板腺可挤压性评分（MGEx）、Schirmer I试验、眼球结膜充血评分（OBRS）和眼表疾病指数（OSDI）。评估眼压（IOP）、最佳矫正视力（BCVA）和角膜内皮细胞计数（ECC）以确保安全性。该临床试验于2023年12月25日在ClinicalTrials.gov网站注册（NCT06158984）。
比较基线和4周测量结果发现，IPL组在NITBUT（IPL：8.74±2.60秒 vs CT：5.76±1.75秒，<0.01）、TMH（IPL：0.23±0.05毫米 vs CT：0.19±0.06毫米，=0.011）、CS（IPL：1.14±0.56 vs CT：1.95±1.17，=0.005）、TFLL（IPL：2.91±2.91 vs CT：3.36±0.58，=0.047）、MGEx评分（IPL：1.14±0.35 vs CT：1.45±0.51，=0.020）和OSDI评分（IPL：31.77±15.59 vs 50.59±21.55，=0.002）方面有显著改善。相反，其他参数没有显著改善（>0.05）。
使用局部抗青光眼药物的患者，如果眼表疾病的进展未得到解决，可能会恶化。然而，IPL疗法有可能使干眼症的客观和主观指标都得到显著改善。最佳矫正视力、内皮细胞计数和眼压被确定在允许范围内。在研究过程中未报告不良事件。
