Ivermectin 1% Combined With Intense Pulsed Light Treatment for Dry Eye Disease Secondary to Demodex Blepharitis

To examine the safety and efficacy of combined treatment with topical ivermectin 1% and intense pulsed light (IPL) for dry eye disease (DED) secondary to demodex blepharitis.

A retrospective review of medical files of patients treated at a private clinic specializing in DED between November 2022 and February 2024 was performed. Sixty-one patients aged 18 years or older with DED because of demodex blepharitis, who received the IPL and ivermectin 1% combination therapy, were included. IPL was applied to the periocular area 4 times at 2- to 3-week intervals, and ivermectin 1% once daily for 1 to 2 months. Both eyes (n = 122) of each patient were evaluated before and immediately after treatment cessation. Blepharitis, meibomian gland secretion, corneal staining, patient satisfaction, and overall clinical improvement were recorded.

Mean age was 59.6 ± 17.6 years and 50.8% (n = 31) were males. Meibomian gland secretion grading improved significantly after treatment from 2.74 ± 0.63 to 1.63 ± 0.63 ( P < 0.001). Blepharitis was eliminated after treatment in 77.0% of patients (23.0% after treatment vs. 100.0% before, P < 0.001). The patient satisfaction rate was moderate to high (range 0-2, mean 1.54 ± 0.60). Clinical improvement rate was moderate to high as well (range 0-2, mean 1.52 ± 0.50). No significant side effects were observed.

The combined application of topical ivermectin and IPL to the facial area induced significant improvement of demodex blepharitis and meibomian gland secretion grading along with a high rate of patient satisfaction. Further randomized controlled double-blinded studies are needed.