The combined impact of intense pulsed light combined and 3% diquafosol ophthalmic solution on evaporative dry eye: a randomized control study

Introduction
The primary objective of this study is to assess whether the combination of intense pulsed light (IPL) with 3% diquafosol (DQS) ophthalmic solution is more effective than intense pulsed light in alleviating signs and symptoms of dry eye disease (DED).

Methods
This randomized study included 66 participants with evaporative dry eye (EDE) who received IPL + DQS therapy (n = 44 eyes), IPL therapy (n = 44 eyes), or sham therapy (n = 44 eyes). All participants were examined at baseline (D0), day 14 (D14), and day 28 (D28) for non-invasive break-up time (NITBUT), tear-film lipid layer (TFLL), corneal conjunctival staining (CS), meibomian gland quality (MGQ), meibomian gland expression (MGEx), and ocular surface disease index (OSDI).

Results
At day 28, comparison among the IPL + DQS therapy, IPL therapy, and sham therapy found significant differences in the mean NITBUT (12.03  ±  1.27 versus 10.47  ±  3.48 versus 4.57  ±  0.46; p  <  0.001), TFLL (2.09  ±  0.29 versus 2.27  ±  0.45 versus 2.89  ±  0.65; p  <  0.001), CS (1.43  ±  0.82 versus 1.93  ±  1.32 versus 3.52  ±  1.00; p  < 0.001), MGQ (1.55  ±  0.66 versus 1.91  ±  0.77 versus 2.66  ±  0.53; p  <  0.001), MGEx (1.27  ±  0.45 versus 1.75  ±  0.44 versus 2.41  ±  0.50; p  <  0.001), and OSDI score (19.36  ±  7.01 versus 24.77  ±  4.68 versus 42.61  ±  7.49; p  <  0.001); significant improvements in NITBUT, TFLL, CS, MGQ, MGEx, and OSDI were found in the IPL + DQS therapy and IPL therapy, while the sham therapy had no significant improvements.

Conclusion
Combining 3% diquafosol ophthalmic solution with intense pulsed light was superior to IPL therapy alone in relieving the signs and symptoms of patients with severe evaporative DED.