Eyeworld

MAR 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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March 2012 Dry eye February 2011 EW SECONDARY FEATURE 97 bank to prepare it for you. [AST] can be helpful, but it's not used fre- quently because of the hassle that comes with making it." For detailed instructions on making the serum, see the box on page 96. Intense pulsed light In 2002, Rolando Toyos, M.D., medical director and founder, Toyos Clinic, Memphis, discovered intense pulsed light (IPL), normally reserved for rosacea and skin rejuvenation patients, came with a happy side effect: It reduced the severity of dry eye symptoms. "We started doing studies in 2004 to look at this further," he explained. "What we saw in our studies is if we did IPL, patients sys- tematically were getting better and their tear break-up time increased." IPL is suitable for patients with moderate to severe meibomian gland dysfunction. "Essentially what we found when we did IPL on these patients [was] small abnormal telangiectasia that were around the gland were closed off," he explained. "We found this light was absorbed in the dermal area, so it bypasses the epidermal and goes into the dermas. It melts these thick secretions and dilates the glands so we can do easy gland expression." Patients can have some relief from IPL alone, but to get the full effect of the treatment, Dr. Toyos recommended gland expression. Insurance does not cover the full cost of IPL. Dr. Toyos charges $400 a treatment, but other physicians charge up to $800. Physicians interested in trying IPL for dry eye shouldn't dust off any old IPL equipment lying around. "When people read IPL helps with dry eye, they immediately want to take out an old system and try it," Dr. Toyos said. "The problem is they'll cause scarring on the face. It took us 7 years to configure an IPL system for dry eye. Most [IPLs] are made for photofacials, which is a lot of energy because you're trying to stimulate collagen." African-American patients cannot have IPL because their skin could burn and lighten. IPL is an ongoing treatment program with patients receiving the therapy once a month until symptoms improve. Maintenance treatments are needed throughout the year. Dr. Toyos expects to publish 3- year clinical follow-up data for IPL in the near future. Results, he said, are excellent. "More than 90% of patients that get the treatment have symptomatic relief," he said. EW Editors' note: Dr. Carlson has financial interests with TearScience. Drs. Glasser and Toyos have no financial interests related to this article. Contact information Carlson: alan.carlson@duke.edu Glasser: dbg@comcast.net Toyos: rostar80@gmail.com OCu uSOFT IntroducesOCuSOFT Introd ® duces Retain lubrica Retaine e® MGD ™ is a revol is a revolutionarlutionary preserv ativ lubricates and protects moderate to severe dry eyes. ates and protects modderate to severe dry e Retainee® MGD™ Droplets Dropletts Ocular Surface E ELECTROSTTA t # OET QPTJUJWFMZ DIBSH F #JOETJ DPSOFBM FQJUIFMJVN DPSOFBM FQJUIFMJVN t 3FQMFOJTIFT UIF MJQJE MBZFS PG UIF UFBS GJMN UP QSPUFDU BHBJOTU NPJTUVS 3FQMFOJTIFT UIF MJQJE MBZFS PG UIF UFBS GJMN UP BHBJOTU NPJTUVSF MPTT BOE QSPWJEF MPO H MBTUJOH DPNGPSU MPTT BOE QSPWJEF MPOH MBTUJOH DPNGPSU For FRFor F R REEEE samples www etainebr www .reta ainebrand.com samples and d m more information, call (800 233-546 l (800)) 233-54699 or r visit ASCRS Boo RS Booth #1101 © 2012 OCuSOFT, Inc., Rosenber osenberg, TX 77471 USA AT ATIC AT ATTRACTION TTRACTTION QPTJUJWFMZ DIBSHFEE J JPOT UP UIF OFHBUJWFMZ DIBSHFE POT UP UIF OFHBUJWFM Z DIBSHFE ative-free ophthalmic emulsion tha ve-free ophthalmic yes. emulsion that moit moisturizes,

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