THERMADRY
It is an Intense Pulsed Light system under exclusive LIUR® technology, specifically designed for the treatment of dry eye. It is a system to facilitate the stimulation and reactivation of the Meibomian glands in the treatment of dry eyes. It is a non-invasive procedure that does not require anesthesia or interfere with daily life. Intense Pulsed Light technology is one of the innovative new technologies recognized in the TFOS-DEWS II report.
The LIUR (Ultra Regulated Intense Light) technology differs from other traditional technologies, which has been designed to reduce or eliminate those risks of application (towards the patient). This Ultraregulation of the LIUR pulses produces a stimulation effect of the natural processes of tissue regeneration, and in no case of aggression or tissue damage.
Dry eye disease of the 21st century
Dry eye syndrome is a chronic eye problem that appears when the tear film dries up more quickly than usual, the eyes do not produce enough tears to stay moist, or when tears do not do their job properly or spread properly over the eye. to the surface of the eye, largely due to the deficient secretion of the Meibonian glands that are in the thickness of the eyelids.
This multifactorial and complex condition goes beyond what is known as “not having tears”. Its consequences can range from mild but constant eye irritation to significant inflammation, and even the appearance of scars on the front surface of the eye.
The I.P.L system Thermadry® Liur® (Ultra-Regulated Intense Light), emits trains of micro-pulses of non-coherent light designed to accumulate the chosen energy density without damaging the tissue and respecting the standard cooling coefficients of the skin. The absolute filtering of UV emission and the ultra-regulation of the pulse trains allow working without the usual risks in other typical intense pulsed light systems. The LIUR system favors the stimulation and reactivation of the Meibomian glands in the treatment of eye dryness
Treating the source of dry eyes optimizes long-term results.
How do tears work?
Tears keep our eyes moist and smooth, and help focus light so we can see clearly. They also protect the eyes from infection and irritants like dirt and dust.
Every time we blink, a thin film of tears known as the “tear film” spreads across the surface of the cornea (the clear outer layer of the eye). Tears emanate from glands above the eyes, then drain into the tear ducts (small holes in the inner corners of the eyes next to the nose) and down the inside of the nose.
When your eyes don’t produce enough tears, or your tears don’t work the right way, you can develop dry eye syndrome.
Clinical manifestations of dry eye
The symptoms vary both in intensity and frequency.
- Gritty sensation in the eyes
- Red eyes
- Itching or stinging
- Decreased visual acuity
- Irritation
- Aversion to light
- Dry eye
- Excessive tearing (the problem is that the quality of the tear is not good and it evaporates quickly)
Action mechanism
- It stimulates peripheral circulation and micro-circulation and reduces inflammation (Ceylan 2004 and Enwemeka 2004).
- Microcoagulation of telangiectasias of the eyelid free edge and the neovessels that surround the Meibomian Glands (Jiang 2016).
- It activates the production of Prostaglandins with an anti-inflammatory effect (Bjordal 2006 and Nesterdstad 2015).
- It stimulates the recovery of Meibocytes by increasing ATP production (Cameron 2009) and accelerates cell metabolism (Smith 1991, Fulop 2006 and Amid 2014).
- Direct antibacterial effect (Nusbaum 2002) and indirect by stimulating the appearance of macrophages and their bacterial phagocytic activity (Plaja 2003).
- It stimulates fibroblasts, increasing the synthesis of mucopolysaccharides and collagen, helping tissue regeneration (Wuddruff 2004 and Plaja 2003).
- Neurostimulation of the parasympathetic nerve. Tear production is stimulated by the nervous system, via the parasympathetic nerve, which is linked to both the lacrimal gland and the meibomian glands.
- Rapid response of the Meibomian Gland Metabolism.
- Increased expression of the meibum due to heat.
- Small Vessel Clotting: acts against inflammation of the skin (rosacea) and eyelids (blepharitis).
- Reduces demodex mites.
Treatments to make
The treatment with the Thermadry LIUR system, acts by restoring the normal functioning of the Meibomian glands, reducing inflammation and improving the quality of tears and, for this, four sessions are carried out at a rate of one every 15 days, the first three and the fourth. after a month. The process is repeated every 6 months approximately, although the sessions can be variable depending on the personal response.
Clinical results
Accelerates the metabolism of the meibomian gland and lacrimal gland
by stimulating the parasympathetic nervous system
Stops the vicious cycle of chronic inflammation
clotting new blood vessels and reducing inflammatory agents
Demodex decreases
through coagulation and necrosis of the pigmented exoskeleton
Why? Thermadry?
Thermadry stands out for its micro-pulse energy emission technology.
- It can be applied to all skin types, even Fitzpatrick grade VI.
- It is a painless treatment.
- It does not generate any toxicity.
- Helps maintain skin and related tissues in optimal condition.
- Activates the natural systems without attacking the tissues.
- It does not require additional cooling systems.
- Very quiet device.
Exclusion criteria
Before carrying out a treatment, the following indications must be observed to prevent adverse skin reactions.
01.
Do not sunbathe or perform UVA sessions before treatment to avoid increasing skin pigmentation and making it easier to produce a burn.
02.
Treat only on intact skin, not on open wounds. This also implies not treating after chemical and/or physical peels (dermabrasion).
03.
Do not treat, under any circumstances, on tattoos or micropigmentation of the lips or eyebrows, it can cause burns and/or change the pigmentation of the tattoo or micropigmentation.
04.
Do not treat pregnant women.
05.
Do not treat pigmented lesions (moles, nevus…).
06.
Caution on epileptic people since the possible tension/fear and the use of Intense Light can trigger an attack.
07.
Do not treat people who are undergoing treatment where photosensitizing products are used, even up to 6 months after the end of treatment (Acne treatments with Roacutan®), to avoid photosensitization reactions: antipsychotic drugs, antidepressants, steroidal anti-inflammatories, antimicrobials, antiparasitics.
LITERATURE
A retrospective study of the efficacy of intense pulsed light delivered by the Lacrystim® for meibomian gland dysfunction therapy -Marie Caroline Trone1,2*, Thibaud Garcin1,2, Edouard Ollier3,4, Gilles Thuret1,2 and Philippe Gain1,2
- Therapeutic Effect of Intense Pulsed Light (IPL) Combined with Meibomian Gland Expression (MGX) on Meibomian Gland Dysfunction (MGD) Shanshan Wei, Xiaotong Ren, Yuexin Wang, Yilin Chou, and Xuemin Li
- Analysis of Cytokine Levels in Tears and Clinical Correlations After Intense Pulsed Light Treating Meibomian Gland Dysfunction – LIU, R et al. – American Journal of Ophthalmology (2017).
- Treatment of ocular rosacea – Edward Wladis et al. – Survey of Ophthalmology (2018), Vol. 63.
- Improved telangiectasia and reduced recurrence rate of rosacea after treatment with 540 nm-wavelength intense pulsed light: A prospective randomized controlled trial with a 2-year follow-up – Luo,Y. et al. – Experimental and Therapeutic Medicine (2020), Vol. 19.
- Therapeutic Effect of Intense Pulsed Light on Ocular Demodicosis – Zhang, X., et al. – Current Eye Research 2019, Vol. 3.
- Intense Pulsed Light Therapy for Patients with Meibomian Gland Dysfunction and Ocular Demodex Infestation – Cheng et al. – Current Medical Sciences (2019), Vol. 39.
- Long-term effects of intense pulsed light treatment on the ocular surface in patients with rosacea-associated meibomian gland dysfunction – Seo Kyoung Yul et al. – Contact Lens and Anterior
Eye (2018), Vol. 41. - TFOS DEWS II Tear Film Report – Willcox Mark et al. – The Ocular Surface (2017), Vol. 15.
- Intense Pulsed Light for the Treatment of Dry Eye Owing to Meibomian Gland Dysfunction – Vigo, L. et al. – Journal of Visualized Experiment (2019), N°146.
- Meibum Expressibility Improvement as a Therapeutic Target of Intense Pulsed Light Treatment in Meibomian Gland Dysfunction and Its Association with Tear Inflammatory Cytokines – Choi,
M. et al. – Scientific Reports (2019), Vol. 9. - Multicenter Study of Intense Pulsed Light Therapy for Patients with Refractory Meibomian Gland Dysfunction – Reiko Arita, et al. – Cornea Volume 37, Number 12, December 2018.
- Rosacea: Molecular Mechanisms and Management of a Chronic Cutaneous Inflammatory Condition – Yu Ri Woo, et al. International Journal of Molecular Sciences, September 2016.