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Dry eye specialist Cory Lappin, OD, of Cincinnati shares insights on IPL that he’s developed from many years of performing the procedure. Dr. Lappin begins with a clear and concise explanation of how light interacts with pigment at the cellular level to “kick-start” meibocyte activity and target telangiectatic blood vessels. He addresses common misconceptions about IPL, taking care to explain that it is a non-laser and non-thermal procedure, as a way of understanding where it fits in among dry eye interventions.
From there, Drs. Lappin, Abbott and Pucker discuss ideal candidates—most notably those with ocular rosacea but also many typical MGD patients—and how to discern their suitability based on Fitzpatrick skin type. The trio also delves into cautions and contraindications in patients on doxycycline, those with active herpetic outbreaks, epilepsy patients, people with skin conditions like melasma and the hazards posed by eyeliner tattoos.
A discussion on technique explains the three main protocols for IPL—Toyos (high fluence), Epstein (overlapping lower-fluence pulses) and Periman (full-face treatment)—and how choice of light filter can affect results.
The conversation concludes with practical tips for patient education on IPL and how to establish a schedule for treatment (beginning with four sessions at a minimum) and long-term monitoring (ideally every three to six months thereafter). Dr. Lappin also gives advice for clinicians who are interested in adding IPL but apprehensive: gain confidence by thoroughly understanding it first, start with ocular rosacea patients and others likely to get great results, and don’t feel you have to sell the patient—educate, don’t attempt to “convince,” and let them decide for themselves.
Relevant articles worth reading:
Ocular Rosacea: How to Recognize and React
By Kaleb Abbott, OD, MS
The Role of Intense Pulsed Light in OSD Management
By Harriette Canellos, OD, and Christina Canellos, OD
Edited by Paul C. Ajamian, OD
Tackle MGD with These Hands-on Interventions
By Mila Ioussifova, OD, and Hardeep Kataria, OD
