Intense pulsed light‑based treatment for the improvement of symptoms in glaucoma patients treated with hypotensive eye drops  

作　　者：Jose Maria Martinez‑de‑la‑Casa Carlos Oribio‑Quinto Almudena Milans‑del‑Bosch Pilar Perez‑Garcia Laura Morales‑Fernandez Javier Garcia‑Bella Jose Manuel Benitez‑del‑Castillo Julian Garcia‑Feijoo David P.Pinero 

机构地区：[1]Ophthalmology Unit,Department of Ophthalmology and ORL,Faculty of Medicine,Hospital Clinico San-Carlos,Universidad Complutense de Madrid,Instituto de Investigacion Sanitaria del Hospital Clinico San-Carlos(IdISSC),28040 Madrid,Spain [2]Department of Immunology,Ophthalmology and ORL,School of Medicine,Instituto de Investigaciones Oftalmologicas Ramon Castroviejo,Universidad Complutense de Madrid,Madrid,Spain [3]Department of Optics,Pharmacology and Anatomy,University of Alicante,Alicante,Spain

出　　处：《Eye and Vision》2024年第2期12-21,共10页眼视光学杂志（英文）

摘　　要：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 treatm

关 键 词：GLAUCOMA Intense pulsed light Dry eye Meibomian glands 

分 类 号：R775[医药卫生—眼科]