The Quality Of Vision In Over Evaporative Dry Eye Patients After Intense Pulsed Light(IPL)treatment

Purpose: To investigate the effect of intense pulsed light on vision quality in dry eye.Methods:From January 2019 to March 2019,64 patients(128 eyes),age 36.09±11.13 years old,25 males,39 females,diagnosed as meibomian gland dysfunction,(MGD)mgd-related moderate to severe dry eye in the outpatient department of He eye hospital in Shenyang were selected.Every three weeks for the patient on a SOLARI system(Lutronic Corporation,Ilsan,Chesapeake)of intense pulsed light(IPL)intensepulsedlight,treatment,a total of 2 times.Treatment areas included bilateral suborbital skin from the nasal side to the temporal side of the cheek.The target treatment area received a total of 12 points of IPL treatment,with the therapeutic contact points of each probe either continuous or slightly overlapping to cover the entire treatment area.This experiment adopts the self-controlled research method.Clinical ophthalmologic examination was performed before treatment(baseline)and on day 21 and 42 after treatment,respectively,as an evaluation indicator.All inspection results were collected as raw data for statistical analysis.Clinical evaluation indicators include:Subjective questionnaires and eye exams at baseline and day 21 and 42 after treatment,Including ocular surface disease index scale(OSDI),quality of visual questionnaire(QOV),non-invasive tear break-up time(NITBUT),tear film lipid layer(TFLL)analysis,eyelid edge shape score,meibomian gland secretion and secretions score,corneal fluorescein staining(CFS),conjunctival congestion jealous analysis(CH),meibomian gland(MG)structure form,best corrected visual acuity(BCVA),corneal endothelial cell counts(ECC)and intraocular pressure(IOP),etc.All patients were required not to accept or use any other treatment associated with local or systemic dry eye or meibomian gland dysfunction during the study.Results: Before and after treatment,64 patients(n=128 eyes)had decreased OSDI score,before treatment(35.49±21.43)and day-42 after treatment(24.01±15.93),the differencewas statistically significant(P < 0.05).Diurnal QOV score was improved,QOV(8.30±1.40)during the day before treatment,QOV(9.14±0.75)during the day after42 nd day,the difference was statistically significant(P < 0.05),QOV(7.36±1.52)during the night before treatment,QOV(8.07±0.77)during the night after 42 nd day,the difference was statistically significant(P < 0.05).NIBUT improved,before treatment(9.68±5.51 seconds),42 days after treatment(18.11±5.01 seconds),the difference was statistically significant(P < 0.05).Quality before and after treatment of meibomian gland secretion and secretion function were improved,the quality score before treatment of meibomian gland secretion(2.17 + /-0.77),42 days(0.82 + 0.53)after treatment,the difference was statistically significant(P < 0.05),treatment of meibomian gland secretion before scoring(2.11 + /-1.13),42 days(0.97 + 0.96)after treatment,the difference was statistically significant(P < 0.05);The lipid layer was significantly improved before and after treatment(3.61±0.50)and 42 days after treatment(1.93±1.25),with statistically significant differences(P < 0.05).Patients' visual quality was improved before and after treatment.QOV score before treatment: glare(1.24±0.59),halo(0.15±0.17),blurred vision(1.20±0.15),blurred vision(2.12±0.27).Glare(0.93±0.45)(P<0.05),halo(0.05±0.50)(P<0.05),blurred vision(0.31±0.15)(P<0.05)and blurred vision(0.18±0.27)(P<0.05)were significantly improved compared with baseline,and the differences were statistically significant.Corneal fluorescein staining and ocular redness analysis(CH)showed no significant improvement on the 42 nd day after treatment(P>0.05).In the visual quality questionnaire,the symptoms of starlight,visual deformation and visual ghosting did not significantly improve before and after treatment,and the differences were not statistically significant(P>0.05).In the whole treatment process,the patients' best corrected visual acuity,intraocular pressure and corneal endothelial cell count did not change significantly before and after treatment,and the differences were not statistically significant(P>0.05).During the whole treatment and observation period,the subjects had no complaints of discomfort,no complications and no adverse events.Conclusions: Intense pulsed light(IPL)treatment can effectively improve the visual quality of patients with moderate to severe evaporative hyperintense dry eye(DE)related to meibomian gland dysfunction(MGD).Improve the symptoms of discomfort caused by dry eyes,effectively improve the function of meibomian gland,improve the stability of tear film;IPL treatment has high safety.