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Transcutaneous radiofrequency treatment helps alleviate dry eye signs and symptoms


Lead author Sean Paul, MD, reports radiofrequency treatment in conjunction with expression of the meibomian glands reduces the signs and symptoms of dry eye disease.

(Image Credit: AdobeStock/Yakov)

(Image Credit: AdobeStock/Yakov)

Radiofrequency treatment in conjunction with expression of the meibomian glands reduces the signs and symptoms of dry eye disease,1 reported lead author Sean Paul, MD. He is from the Department of Oculoplastic Surgery, Austin Face and Body, Austin, TX.

He and his colleagues explained that because meibomian gland dysfunction disrupts tear film homeostasis and results in dry eye syndrome, they wanted to explore if transcutaneous radiofrequency-assisted meibomian gland expression can effectively treat dry eye syndrome.

They conducted a multicenter, prospective cohort study of patients with dry eye using the Envision platform that includes the Forma-I handpiece (InMode) to apply the treatment. The study ran from October 2019 to June 2022.

The investigators explained that the platform delivers energy that differentially heats the tissue by the impedance of the electromagnetic current.

The primary study endpoints were the changes in the following parameters: the standard patient evaluation of eye dryness (SPEED) questionnaire score,ocular surface disease index (OSDI), tear breakup time (TBUT), corneal fluorescence score (CFS), and meibomian gland score (MGS) at 1, 3, and 6 months after treatment. The secondary endpoints were the patients' subjective improvement and subjective satisfaction with the treatment.

Radiofrequency results

Forty-seven patients were enrolled initially at three separate institutions., but 15 were excluded because of incomplete data, leaving 32 patient who completed the follow-up.

The authors reported significant improvements in all parameters evaluated.

The SPEED score improved compared with baseline, 15.7 vs 11.4 at 1 month, 9.1 at 3 months, and 9.6 at 6 months (p<0.05). the OSDI improved at all time points measured, 34.5 at baseline vs 25.2 at 1 month, 21.2 at 3 months, and 23.6 at 6 months (p<0.5). The CFS decreased significantly in each eye at all time points, with 80% of eyes responding. The TBUT similarly improved after treatment in each eye with an average of 6.3 seconds at 1 month, 7.1 seconds at 3 months, and 7.1 seconds after treatment at 6 months vs 2.8 seconds at baseline. The MGS also improved markedly at all time points, 5.6 at baseline vs 19.9 at 1 month, 24.7 at 3 months, and 22.9 at 6 months. Patients reported subjective improvement, ie, no pain and discomfort related to the treatment.

The investigators commented, “This pilot study demonstrates that radiofrequency treatment with the Forma-I handpiece along with meibomian gland expression is an effective means to reduce the signs and symptoms of dry eye disease. The data support the conclusion that the treatment is safe and effective, lasting at least 6 months in most patients. Patients believed the treatment significantly improved from their baseline and reported high satisfaction. No complications were reported within the follow-up period. Across all endpoint metrics, the treatment was considered a success in treating dry eye symptoms.”

  1. Paul S, Cohen A, Parsa K, et al. Transcutaneous radiofrequency-mediated meibomian gland expression is an effective treatment for dry eye: a prospective cohort trial. Open Ophthalmol J. 2023; doi: 10.2174/18743641-v17-e230328-2022-63
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