Rexon-Eye for dry eye: the electrotherapy option for stubborn, multifactorial dry eye
Most dry eye device treatments, including LipiFlow, IPL and Tixel, work by delivering heat to unblock the oil glands. Rexon-Eye takes a different route, which is what makes it worth understanding for people whose dry eye is mixed or has an inflammatory component and who have not been fully helped by heat-based treatment.
What Rexon-Eye does
Rexon-Eye uses low-power, high-frequency (4 to 64 MHz) alternating current, a technology called quantum molecular resonance (QMR). A mask with one electrode per eye rests on closed eyelids and delivers a painless electrical field to the lids and surrounding skin for 20 minutes, once a week for four weeks. The proposed mechanism is reduced inflammation and stimulation of the lid and surface tissues, rather than simply warming the glands.
The randomised, double-blind trial
The strongest evidence is a double-blind randomised controlled trial of 40 patients, 20 per group, comparing four weekly Rexon-Eye sessions with a placebo session using the same device (Shemer et al., Cornea, 2023). A randomised, double-blind design means neither patients nor examiners knew who had real treatment, which is the best protection against expectation shaping the results.
- Symptoms (OSDI, 0 to 100): fell from 19.2 to 10.5 in the treated group (P < 0.001), while the placebo group went from 14.4 to 15.5 (no change).
- Meibomian gland score: improved from 1.57 to 0.8 with treatment (P = 0.006) versus 1.60 to 1.99 with placebo.
- Corneal staining (surface damage) improved with treatment (P = 0.045).
- No difference between groups in tear break-up time, vision or Schirmer test (tear production).
- No harms were reported.
The mean difference between groups is simply the average gap between the treated and placebo results; this trial reported changes within each group rather than a between-group estimate with a 95% confidence interval (the range within which the true effect most likely sits), so precision is hard to judge. Note also that the treated group started with somewhat worse symptoms (19.2 versus 14.4), which leaves more room to improve.
Two uncontrolled studies in mixed-type dry eye
A Greek hospital series treated 51 patients (102 eyes) with dry eye from mixed causes: 27 with MGD, 18 with autoimmune-related surface disease such as Sjögren's, four after cataract surgery and two with glaucoma (Kavroulaki et al., Cureus, 2023). Symptom scores fell from 10.8 to 7.6 straight after the fourth session and 6.4 two months later (P < 0.001), and lipid-layer thickness by interferometry rose from 53.3 to 58.1 and then 59.8. Tear break-up time and gland loss did not change at end of treatment; two months later the changes were statistically significant but tiny (break-up time 7.50 to 7.59). Only 32 of the 51 patients (63%) returned for the two-month check, there was no comparison group, and the questionnaire appears to be a 0-to-28 SPEED-type scale rather than the 0-to-100 OSDI. No adverse events, burns or side effects were recorded.
An Italian study treated 18 patients with medium-to-severe mixed-type dry eye using the same four-week protocol and examined them one month after the last session (Trivli et al., Journal of Optometry, 2023). It was prospective but non-randomised, with no control group. Symptoms improved (OSDI, P = 0.013), as did non-invasive break-up time (P < 0.001), corneal staining (P = 0.002), the number of expressible glands (P = 0.001), oil quality (P < 0.001) and the inflammatory marker MMP-9 in the tears (P = 0.003). Tear volume (meniscus height) and the Schirmer test did not change significantly, and gland structure on meibography was unchanged. No adverse events were reported. Only the abstract was available to us, so effect sizes cannot be quoted.
What the studies can't tell us
The controlled trial is small, 20 people per arm, and did not report confidence intervals, so the size of the true effect is uncertain. The two mixed-type studies had no sham or untreated group, which means they cannot separate the device from placebo, natural fluctuation or other treatment people were using at the same time, and one lost more than a third of participants before its final visit. Follow-up in all three studies was one to two months after the last session, so durability beyond that is unknown. None of the studies compared Rexon-Eye with LipiFlow, IPL or Tixel. And a point that matters for people with aqueous-deficient dry eye: across all three studies, measures of tear production (Schirmer, tear meniscus) did not improve. The measurable benefits so far are in symptoms, gland function, lipid layer and inflammation, not in making more tears. No funding statements were available for the three papers.
Where it fits
Rexon-Eye is not usually the first thing to try for straightforward evaporative dry eye; heat-based treatment of the glands is better established for that. Its role is as an option for stubborn, mixed or inflammation-driven dry eye, or for people who have not had enough relief from other approaches. The assessment comes first: the right treatment depends on which kind of dry eye you have, and dry eye remains a chronic condition that is managed, not cured.
Being assessed in New Zealand
Rexon-Eye is among the treatments available through the Dry Eye Specialist Group network. A full assessment measures your tear film and images your glands so your treatment is matched to your diagnosis. You can find your nearest clinic or call 0800 349 379. The Dry Eye Evaluation is a paid consultation. The New Zealand Eye Research Centre follows the evidence base for these newer treatments as it grows.
This article is general information and not a substitute for a clinical assessment. Whether Rexon-Eye suits you depends on an examination of your own eyes.
References
Sourced and verified via PubMed.
- Shemer A, Altarescu A, Nusbaum L, et al. Quantum Molecular Resonance Effects on Patients With Dry Eye Disease: A Randomized Controlled Trial. Cornea. 2023 (print 2024;43(9):1144-1149). PMID 38166187. https://doi.org/10.1097/ICO.0000000000003443
- Kavroulaki D, Konstantinidou E, Tsiogka A, Rallis K, Mavrikakis E. Quantum Molecular Resonance Electrical Stimulation as a Beneficial and Safe Treatment for Multifactorial Dry Eye Disease. Cureus. 2023;15(5):e39695. PMID 37398748. https://doi.org/10.7759/cureus.39695
- Trivli A, Karmiris E, Dalianis G, Ruggeri A, Terzidou C. Evaluating the efficacy of Quantum Molecular Resonance (QMR) electrotherapy in mixed-type dry eye patients. J Optom. 2023;16(2):128-134. PMID 35851496. https://doi.org/10.1016/j.optom.2022.06.003
