Subjective Quality of Vision in Evaporative Dry Eye Patients After Intense Pulsed Light

Background and objective: Intense pulsed light (IPL) improves visual and clinical symptoms of dry eye disease and helps improve meibomian gland (MG) function thereby positively contributing to the tear lipid layer, a major component for a normal tear film physiology. The objective of this study was to assess the effectiveness of IPL in moderate to severe evaporative dry eye (DE) owing to meibomian gland dysfunction (MGD) on the subjective quality of vision (QOV). Methods: This is a prospective, open-label study; patients with moderate to severe evaporative DE owing to MGD were consecutively enrolled and underwent two IPL treatment sessions at 3-week intervals. Clinical assessments included: Ocular Surface Disease Index (OSDI) and QOV questionnaires, noninvasive tear breakup time (NITBUT), interferometric fringe pattern as determined by tear film lipid layer (TFLL) quality, lid margin abnormalities, corneal fluorescein staining (CFS), conjunctival hyperemia (CH) redness score, MG (evaluated with a slit-lamp microscope), best-corrected visual acuity, endothelial cell count, and intraocular pressure were conducted at pretreatment, days 21 and 42 after IPL treatment. Results: A total of 128 eyes of 64 patients (39 women, 25 men; mean age 36.09 +/- 11.13 years) with moderate to severe DE owing to MGD consecutively received IPL treatment at days 1 and 21. OSDI (p < 0.05), QOV (p < 0.05), NITBUT (p < 0.05), TFLL score (p < 0.05), and MG quality and expressibility (p < 0.05) improved significantly at day 42, whereas CFS and CH showed minor not significant improvements (p > 0.05) at day 42 of assessment. Conclusions: IPL treatment reduced the severity of DE symptoms and improved the overall tear film stability in patients with moderate to severe evaporative DE owing to MGD. In addition, visual complaints experienced by DE patients secondary to MGD significantly decreased.