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"Also, many patients have come to me after using all of these medications without getting relief.
Finally, some of our patients have not used the drops due to cost or allergy, and they still show positive results.
We found that during some of the time points following treatment, their MGD was better; the lids looked clearer, there was less erythema, fewer blood vessels, thinner secretions, and most important, reduced symptoms." However, the existing technology was inconsistent, and the bulb's intensity would diminish over time. Toyos worked with one of the companies, Dermamed, to solvethese problems.
"Now, we have an instrument that's safe, with reproducible results," he says. Toyos emphasizes that doctors should not attempt this using just any IPL equipment.) Dr.
Brief, powerful bursts of light at specific wavelengths (in this case, between 500 and 800 nm) cause changes in blood vessels near the surface of the skin, raise skin temperature and eliminate problematic flora on the skin and eyes, Dr.
"So, we began investigating this using different IPL instruments, none of which were designed to treat meibomian gland dysfunction," he says. Then in 2003 we received an ASCRS grant to pursue this, and we conducted a small study in which patients with MGD were treated with IPL on one side and nothing on the other side.
Toyos notes that he doesn't directly treat the upper glands.
"First of all, when you hit the side of the lid, you close off blood vessels that feed into the upper glands," he explains.
"Postopera-tively, we have the patient use Durezol for three days, and Xibrom once a day until they see us again, for inflammation.
Then we have the patient use Aza Site at night for 10 days before the next treatment." Asked whether the results could be attributed largely to the medications, Dr. "My initial studies were done without any medications, but patients reported improvement and I saw objective improvement," he notes.
Toyos says one immediate effect of IPL is that it acts like the "world's best warm compress." "When the light is absorbed by the blood vessels, it generates heat in the dermal layer that melts the secretions and opens the glands," he explains.