Purpose

To evaluate the feasibility, safety, and preliminary clinical outcomes of combining intense pulsed light (IPL) therapy, meibomian gland expression, and intracanalicular hydrogel occlusion using Lacrifill® in patients with severe dry eye disease.

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Methods

This prospective pilot study included patients with severe evaporative or mixed-mechanism dry eye disease undergoing three consecutive IPL treatment sessions combined with meibomian gland expression. Intracanalicular hydrogel occlusion using Lacrifill® was performed to improve tear retention during treatment. Clinical assessment included Ocular Surface Disease Index (OSDI), tear break-up time, tear meniscus height, ocular surface comfort, and treatment tolerance. Feasibility of repeated meibomian gland expression following Lacrifill® placement was also evaluated.

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Results

Preliminary observations demonstrated improvement in ocular surface symptoms, tear film stability, and patient-reported comfort following combined therapy. The treatment protocol was well tolerated, with no canalicular obstruction, infection, epiphora, or significant adverse events observed during follow-up. Meibomian gland expression remained feasible throughout serial IPL treatment sessions after Lacrifill® placement. Patients reported reduction in irritation, fluctuating vision, and ocular discomfort following combined management.

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Conclusion

Combined IPL therapy, meibomian gland expression, and intracanalicular hydrogel occlusion appear to represent a safe and feasible multimodal strategy for severe dry eye disease. This approach addresses both evaporative dysfunction and tear retention and may provide symptomatic and ocular surface improvement in selected patients. Larger studies with longer follow-up are required to further evaluate efficacy and optimal treatment sequencing.

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Additional Authors

First name	Last name	Base Hospital / Institution
Mariam	Davitashvili	Vissum Grupo Miranza Alicante

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