Results of a study designed to investigate the addition of microdermabrasion to intense pulsed light (IPL) therapy in patients with meibomian gland dysfunction (MGD) and dry eye syndrome corroborate the efficacy of IPL for increasing tear break-up time (TBUT) and decreasing dry eye symptoms but fail to confirm the hypothesis that the benefits of IPL may be enhanced by microdermabrasion, said Dr Rolando Toyos at the annual meeting of the American Society of Cataract and Refractive Surgery (ASCRS).

In a previous study supported by an ASCRS research grant, Dr Toyos used IPL to treat 100 patients with MGD and dry eye syndrome who remained symptomatic despite use of many prior therapies. They received IPL at four sessions spaced 4 to 6 weeks apart with the treatment area encompassing the midface from the tragus to the nose bilaterally. The results showed TBUT increased significantly from baseline and there were also symptomatic improvements measured by responses to a subjective questionnaire.

The study of adjunctive dermabrasion enrolled 15 patients with MGD and symptomatic dry eye who had a TBUT <6 seconds. The patients again underwent IPL across the entire midface, but microdermabrasion was performed on one side only prior to IPL. Patients were treated until symptoms resolved, for total of two to four treatments.

TBUT increased in both eyes of all patients, with the change from baseline ranging from 3 to 12 seconds. However, the mean improvement was numerically greater for the side treated with IPL alone compared with IPL plus microdermabrasion, 5.7 versus 5.2 seconds. In addition, subjective questionnaire responses showed that only two patients achieved greater symptomatic relief on the side where they received microdermabrasion. The remaining patients rated their symptomatic improvement similar on both sides.

"While this study failed to find a benefit for adding microdermabrasion to IPL, it was a small pilot trial and there is reasonable scientific rationale supporting the combination technique," affirmed Dr Toyos, medical director, Toyos Clinic, Memphis, Tennessee, USA. "Therefore, further study seems warranted."