Intense Pulsed Light Treatment for Itch Associated with Allergic Keratoconjunctivitis: A Retrospective Study of 35 Cases.

Objective: To conduct a preliminary assessment of intense pulsed light (IPL) treatment for allergic keratoconjunctivitis (AKC)-associated ocular itch. Background: Current control measures for AKC rely primarily on drugs. IPL is effective for dry eye disease (DED). Furthermore, phototherapy is effective for managing skin inflammation and pruritus, suggesting that eye itching could decrease in some patients having AKC complicated with DED following IPL treatment to control dry eye symptoms. Methods: Thirty-five patients having DED complicated with mid-to-severe AKC were administered three IPL treatments to the periorbital skin. The eye scores of subjective symptoms and signs of AKC and tear film breakup time (TBUT) were retrospectively assessed before and after each treatment. Results: The scores for AKC-related symptoms and signs were determined four times: on Day 1 (time 0), Day 15 (time 1), Day 45 (time 2), and Day 75 (time 3) before each treatment. The average symptom score significantly decreased with treatments (time 0: 30.97, time 1: 15.03, time 3: 10). The average sign score for both eyes decreased after the first IPL treatment (left eye: 7.97 vs. 11.38; right eye: 8.1 vs. 11.1). There were no further improvements in the signs after the last treatment. The TBUT value in the right eye increased from times 0 to 3 (2.31 vs. 4.66 vs. 7.71 vs. 7.74). The TBUT value in the left eye increased from times 0 to 3 (2.50 vs. 6.97 vs. 7.57 vs. 8.24). Conclusions: Symptoms and signs improved after IPL treatment in patients with AKC. Eye itching was gradually controlled and rarely recurred. IPL may be effective for AKC treatment.

Preliminary Assessment of Intense Pulsed Light Treatment on the Upper Eyelids for Meibomian Gland Dysfunction.

Objective: To conduct a preliminary assessment of the intense pulsed light (IPL) treatment on the upper eyelid. Background: IPL therapy is an effective therapy for meibomian gland dysfunction (MGD). The normal treatment region includes the skin below the lower eyelids and both temporal parts, but not the upper eyelid. Methods: Thirty patients with mid-to-severe dry eye disease caused by MGD were selected and randomly divided into two groups. Fifteen controls in group A received normal IPL treatment. Fifteen patients in Group B underwent additional IPL treatment on the upper eyelid. The change in noninvasive tear breakup time (BUT), Ocular Surface Disease Index (OSDI) questionnaire, patient satisfaction, and adverse events were measured and recorded at each visit, before each treatment. Results: The dry eye symptoms of the patients in both groups improved. The patients in group B had better recovery than those in group A: BUT (right eye: 11.6 ± 3.67 sec vs. 7.73 ± 1.99 sec; left eye: 12.73 ± 4.19 sec vs. 7.73 ± 1.40 sec), OSDI (8.87 ± 4.31 vs. 14.93 ± 3.47); patient satisfaction in group B remained good, but decreased in group A with prolonged treatment duration. No serious skin and eye complications were found in any patient. Conclusions: This study showed the patients who received IPL treatment on the upper eyelid experienced improved symptoms of MGD. A further long-term study should be conducted to increase our understanding of the effect of expanded IPL treatment.

Intense Pulsed Light Treatment for Meibomian Gland Dysfunction in Skin Types III/IV.

Background and objective: Several cases of meibomian gland dysfunction (MGD), particularly the moderate to severe ones, are considered intractable by traditional therapy. Intense pulsed light (IPL) therapy has emerged as a new choice for management of MGD in recent years, given that use of lasers and optical treatments is typically challenging in patients with darker skin types. Methods: IPL treatment for MGD is administered in the periorbital area with the thinnest skin in our body, which has an inherent risk of skin side effects. We evaluated the effects and safety of this therapy in Chinese patients with Fitzpatrick skin types III-IV. Forty MGD patients were randomly administered IPL treatment with two types of parameters in the left and the right eye. Results: Results revealed that both parameter settings of IPL treatment could gradually and effectively raise the tear breakup time (BUT) and ocular surface disease index (OSDI) score. However, younger patients showed better improvement in BUT (F = 19.54, p < 0.01) and OSDI (F = 9.93, p < 0.01) compared with older patients. Conclusions: Overall, results showed that IPL treatment is safe and effective in MGD patients with skin types III-IV.

CO2 Laser Treatment of Xanthelasma Palpebrarum in Skin Types III-IV: Efficacy and Complications After 9-Month Follow-Up.

Objective: Ultrapulse CO2 laser has been used for several decades for removal of xanthelasma lesions. However, most studies to date have focused on Caucasian patients (skin types I-II). We sought to assess the efficacy and complications of CO2 laser therapy for xanthelasma palpebrarum (XP) in Chinese patients (skin types III-IV). Methods: Data of 38 patients with xanthelasma who received CO2 laser treatment between December 2013 and January 2016 at our hospital were retrospectively analyzed. Patients were followed up for 9 months. Results: Recurrence occurred in 19/38 (50%) patients. Recurrence was significantly more common in patients with multiple lesions (15/24; 62.5%) than in patients with single lesions (4/14; 28.6%). At 3 months after treatment, the complication rate was 63.16%. The complications included hypopigmentation (23/24; 95.8%) and scarring (1/24; 4.2%). In all patients, the hypopigmentation had disappeared by end of the 9-month follow-up. Conclusions: Ultrapulse CO2 laser appears to be capable of completely removing XP in patients with medium skin type III-IV. The most common complication is hypopigmentation, but this resolves with time.

Complications and posttreatment care following invasive laser skin resurfacing: A review.

OBJECTIVE: Laser skin resurfacing (LSR) has been used for facial rejuvenation for the last 20 years. Posttreatment care after LSR is essential to decrease the risk of complications. Currently, no unified standards or criteria exist for invasive LSR posttreatment care. We aimed to identify the optimal wound care timing and choice of specific local, systemic, and general medical measures required to decrease complications. METHODS: We performed a systematic search of the PubMed/MEDLINE electronic databases and included only articles written and published in the English language, with no restrictions on the publication time (year). RESULTS: The search yielded 316 potentially relevant articles, 133 of which met our review criteria. Most of the studies on this topic have focused on wound care during the early stage, typically the first 2 weeks. Closed dressings may offer a more ideal, moist wound environment. The use of medications must be judicious. The ongoing emergence of new methods and products warrants evaluation in future large clinical trials. SUMMARY: Familiarity with the complications following invasive LSR and the provision of optimal, effective, and timely posttreatment care may substantially decrease the risks associated with the treatment modality.

Intense Pulsed Light: From the Past to the Future.

BACKGROUND: For 20 years, intense pulsed light (IPL) technology has been used to treat various medical problems. IPL has since developed rapidly, becoming popular among patients worldwide. Recently, IPL has been used mainly for cosmetic purposes. Researchers are constantly seeking new applications of IPL to meet the increasing needs of patients. OBJECTIVE: This review summarizes the development of IPL devices, discusses the current literature on the clinical application of IPL to increase our understanding of IPL, and provides guidance for broadening its clinical applications. MATERIALS AND METHODS: We performed a systematic search of electronic databases, including MEDLINE and PubMed and the authors experience on IPL to divide IPL development into three stages: germination, growth, and relative maturity. RESULTS: Studies established the classical indications of IPL, including vascular lesions, pigmented lesions, hair growth, and photo rejuvenation. However, trials showed IPL has limited effects for complicated skin problems. Many studies explored rational combination therapies by IPL and laser or other cosmetic technologies. CONCLUSIONS: Based on previous research and the new generation of IPL devices, in the future, we predict wider and more effective clinical applications of IPL through the further improvement of IPL devices and their combined treatment.

A case of corneoscleral dellen after medial rectus recession combined with pterygium resection in right eye.

PURPOSE: A case of corneoscleral dellen after medial rectus recession combined with pterygium resection was reported. METHODS: Case report RESULTS: A male patient aged 48 years had ghost for 1 year after acoustic neuroma resection. The patient was diagnosed with rectus paresis in the right eye. He successfully underwent medial rectus recession combined with pterygium resection. A corneoscleral dellen with a size of 2×2 mm was observed at 20 d postoperatively. The thinnest cornea was 147um, diagnosed as corneoscleral dellen, which was cured after undergoing corneal limbal stem cell transplantation with conjunctival flap. CONCLUSION: Corneoscleral dellen is non-infectious corneoscleral ulcer caused by complex reasons. Most cases recovered by using artificial tears, antibiotic ointment and eye wrap, and other patients required corneal limbal stem cell transplantation with conjunctival flap, even keratoplasty. It is recommended that the patients with strabismus combined with pterygium underwent conjunctival flap transplantation at early stage to prevent the incidence of surgical complications.