Comparison of IPL versus a certified Ultrasound Probe in Expression of Meibomian Gland Oil for Patients with Eye Pain, Dry Eye, and Meibomian Gland Dysfunction

We have received IRB (Investigational Review Board) approval to study total amounts of meibum expression of IPL (Intense Pulse Light) compared to a certified Ultrasound Probe for Patients with Eye Pain, Dry Eye, and Meibomian Gland Dysfunction. We have a control arm of patients who do not have the above as well. The Ultrasound Probe we used is this one:Ultrasound Probe

Our very preliminary studies, which I hope to post the video here soon, showed the Ultrasound Probe (I have no financial interests in this probe, the IPL machine, or any of the companies involved) to be better in the volume of meibum expressed. We treated 3 patients as follows: 1 eye’s upper and lower lids were treated with standard IPL. The 2nd eye’s upper and lower lids were treated with the Ultrasound Probe. Standard expression was applied. The video shows more oil coming out of the eye treated with the Ultrasound Probe during expression. So far we have treated 2 controls (no MGD or dry eye, etc)  and 1 case (patient has dry eyes but meibomian gland scores were similar between eyes): obviously one would expect the eye that has worse MGD to produce less oil, so we will exclude these patients.

Ideally, we will “blind” the reviewer to which eye was treated with IPL versus the Ultrasound.

I had the Ultrasound Probe certified by an independent phD researcher at George Washington University. We made sure the frequency, wavelength, and Hz would not harm the lens inside the eye. Having said that, the Ultrasound Probe should only be directed away from the center of the eye or lens and not toward the lens. The chance of causing a cataract in this fashion (over years of use) is unlikely. If the probe is directed over the eyeball itself, there is a small risk it could cause a cataract if used over years. This is very unlikely but long term studies have not been done to be sure the risk is zero. Thus the precaution.

More on this soon.
SLC

Also, let me mention here that there is a lot of controversy about which IPL machine is best. To my knowledge, there are no Independent studies (meaning not sponsored by the IPL company) to show one IPL machine is better than another.

Our initial Ultrasound Probe trial shocked me in how much oil was expressed with a simple over the counter Probe compared to an IPL. Thus until there is an independent IPL study, I suspect they are all very similar for patients with dry eye, eye pain, or Meibomian Gland Dysfunction as long as meibomian gland EXPRESSION is performed after the IPL.

The Match Up:

IPL

VERSUS

Ultrasound Probe: Ultrasound Probe: over the counter

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