Most of DED cases have an evaporative component originated from a meibomian gland dysfunction (MGD). Conventional treatments such as tear substitute, warm compresses, topical anti-inflammatory agents and/or antibiotics often are not able to provide a complete and long-term relief of symptoms and signs.
IPL
The technique uses a polychromatic light with a wavelength spectrum of 500–1200 nm which is directed to the skin and absorbed by chromophores such as melanin, hemoglobin and water with the development of heat, thus inducing blood vessels ablation.
Safety
Over the following years, ophthalmologists refined the technique and the devices, aiming at improving results while minimizing complications.
Conclusion about this emerging treatment
Despite its use in the treatment of ocular surface diseases, the mechanism of action of IPL in the setting of DED is still unclear and there is no universal consensus about it.
Procedure
IPL devices allow the regulation of wavelengths, pulse duration, pulse intervals and fluence, thus facilitating the treatment of a wide spectrum of conditions in different patients using a tailored approach.
Safety procedure
Protective eye shields must be placed over the eyes and the treatment area must be free from make-up, shaved and covered with an ultrasound gel. IPL flashes are placed for each eye starting from the inner canthus and ending in the temporal region below the lower eyelid, with slight overlapping applications.
Studies on safety
IPL has demonstrated to be not only effective, but also a safe therapeutic option, as shown by a large amount of studies that reported no major adverse events.
Despite its clinical efficacy, currently there are some limitations: the technology cannot be used in patients with a Fitzpatrick score higher than IV, as deeper pigmented subjects are at a higher risk of skin damage. Moreover, the upper eyelid cannot be directly treated because it is possible for the broad-spectrum light to penetrate and reach underlying ocular structures with potential damages… Other current limitations are related to lack of evidence about the number of sessions that should be performed for each treatment cycle and to the proper interval time that should be waited between each IPL session.