Effects of intense pulsed light on tear film tgf-β and microbiome in ocular rosacea with dry eye

Samantha Sagaser, Richard Butterfield, Heidi Kosiorek, Yael Kusne, Juan Maldonado, Michael P. Fautsch, Dharmendra Patel, Joanne F. Shen

Research output: Contribution to journalArticlepeer-review


Purpose: To assess tear film transforming growth factor-beta (TGF-β) and ocular micro-biome changes after intense pulsed light with meibomian gland expression (IPL-MGX) vs only MGX in treating ocular rosacea with dry eye symptoms. Methods: Twenty patients were randomly assigned to IPL-MGX or MGX. Patients were examined, treated, and administered the ocular surface disease index (OSDI) survey every 4–6 weeks for four total treatments. Tear film and conjunctival samples were collected at first and last visits, and analyzed for TGF-β concentration and 16s rRNA amplicon sequencing of ocular microbiome. Wilcoxon Rank Sum and Sign-Rank were used to examine changes from baseline. Results: OSDI revealed significantly greater improvement in symptoms after IPL-MGX (p=0.030) compared to MGX. There was no significant difference in mean TGF-β1, 2, or 3 concentration after IPL-MGX (p=0.385, 0.709, 0.948, respectively). Quantities of Clostridium, Klebsiella, Brevibacterium, Lactobacillus, Neisseria, Streptococcus, Corynebacterium, Butyricicoccus, and Actinomyces were significantly reduced from baseline in both groups but without a significant difference between the two treatment groups. Conclusion: IPL-MGX improved dry eye symptoms more than MGX alone. IPL treatment offered no additional benefit to MGX in decreasing virulent bacteria present on the ocular surface and did not influence TGF-β levels in tears. Prospective studies on IPL-MGX with larger sample sizes are needed to further investigate cytokines and IPL in patients suffering from ocular rosacea with dry eye symptoms.

Original languageEnglish (US)
Pages (from-to)323-330
Number of pages8
JournalClinical Ophthalmology
StatePublished - 2021


  • Dry eye disease
  • IPL
  • Intense pulsed light
  • Meibomian gland disorder
  • Meibomian gland expression
  • OSDI; ocular surface disease index
  • Ocular microbiome
  • Ocular rosacea
  • TGF-β
  • Tear cytokines
  • Transforming growth factor-beta

ASJC Scopus subject areas

  • Ophthalmology


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