RT Journal Article
T1 Intense pulsed light-based treatment for the improvement of symptoms in glaucoma patients treated with hypotensive eye drops
A1 Martínez de la Casa, Jose Maria
A1 Oribio Quinto, Carlos
A1 Milans del Bosch, Almudena
A1 Pérez García, Pilar
A1 Morales Fernández, Laura
A1 García Bella, Javier
A1 Benítez del Castillo, José Manuel
A1 García Feijoo, Julián
A1 Piñero, David Pablo
AB Background: Ocular surface disease in glaucoma patients is a significant ocular co-morbidity that can affect 40% to 59% of these patients worldwide. The current study was aimed at evaluating the potential clinical benefit of an intense pulsed light (IPL)-based treatment in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop treatments. To our knowledge, this is the first series analyzing the therapeutic effect of this treatment option in this type of patients.Methods: This non-comparative prospective case series study enrolled a total of 30 glaucoma patients ranging in age from 57 to 94 years old and treated with hypotensive eyedrops for years with dry eye symptomatology. All patients received four sessions of IPL treatment using the Optima IPL system (Lumenis, Yokneam, Israel) adjusted to the official optimized Lumenis setting. Changes in symptomatology, corneal staining, conjunctival hyperemia, non-invasive break-up time (NIBUT), tear osmolarity, tear meniscus height (TMH), meiboscore and meibomian gland expressibility was analyzed after treatment.Results: Statistically significant reductions were observed after IPL treatment in the symptomatology scores measured with different questionnaires [ocular surface disease index (OSDI), standard patient evaluation of eye dryness (SPEED) and symptom assessment questionnaire in dry eye (SANDE)] as well as with the visual analogue scale (P < 0.001). Mean change in OSDI was − 15.0 ± 11.3. A significant reduction was found after treatment in the corneal staining score (P < 0.001). A significant reduction was found in tear film meniscus height (P = 0.012), as well as in tear film osmolarity (P = 0.001). A significant reduction was also found in meibomian gland expressibility (P = 0.003), changing the percentage of grade 3 eyes from 44.4% before IPL to 17.2% after treatment.Conclusions: IPL therapy combined with meibomian gland expression (MGX) seems to be an effective option to improve symptomatology in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop treatments, with an additional improvement in clinical signs, such as tear osmolarity and corneal staining.
PB BMC
SN 2326-0254
YR 2022
FD 2022-04-01
LK https://hdl.handle.net/20.500.14352/72877
UL https://hdl.handle.net/20.500.14352/72877
LA eng
NO Received: 12 September 2021; Accepted: 07 March 2022; Published: 01 April 2022
DS Docta Complutense
RD 8 may 2024