Before and After IPL Treatment for Chronic Dry Eye and Rosacea
Fig. 1 Rosacea Pre-IPL
Fig. 2 Post-IPL 2 Months Later
Fig. 3 Meibomian Gland Disease
Fig. 4 Meibomian Gland Disease,
after 2 IPL Treatments
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An IPL treatment uses the power of broadband light to minimize the appearance of age spots, sun spots, acne scars, rosacea, and more. IPL treatments generally take about 20 – 30 minutes. After the patient’s face is cleaned and dried, patients will be given protective eye shields to wear during the procedure. A handheld device will be passed over the target area, delivering pulses of intense light to penetrate the layers of the skin. Most patients describe experiencing a fast, pinching sensation during treatment, with minimal discomfort. There is no need for injections or incisions, giving patients the bonus of no downtime required.
The classic thinking around the use of intense pulsed light (IPL) in treating dry eye is that active signs of inflammation (such as facial and/or ocular rosacea and telangiectasia) or meibomian gland dysfunction (MGD) indicate the treatment might be successful.
While true, there is a wide range of patients for whom IPL is a good option. As has been learned over the past two decades, inflammatory processes are a common factor in all forms of dry eye-evaporative, and aqueous deficient alike.
In short, IPL works for dry eye because it has multiple mechanisms of action, many of which are important regardless of etiology:
- Light energy from IPL warms the meibomian glands, thereby facilitating expression of meibum. There is evidence that IPL helps restore the function and morphology of the meibomian glands.
- The wavelength of light used in IPL is selectively absorbed by telangiectatic blood vessels, which coagulates them. This has a dual outcome, both destroying blood vessels that perpetuate inflammation and decreasing the levels of pro-inflammatory mediators that contribute to dry eye. IPL reduces the load of demodex mites that stimulate infection.
- The light energy in IPL is absorbed by cytochrome C within the mitochondria, which is active in the electron transport chain (ETC). In turn, this improves adenosine triphosphate (ATP) production, which facilitates important cellular functions such as collagen synthesis in fibroblasts and motility in immunoregulatory cells.
As an additional note, IPL treatment also indirectly interrupts the dry eye inflammation cycle by reducing the osmolarity of the tear film to normal levels.
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