Perioperative intense pulsed light to prevent and improve symptoms of post-laser corneal refractive surgery dry eye. A randomized clinical trial

Purpose

To evaluate the efficacy of perioperative IPL therapy in preventing postoperative ocular surface disorders in patients undergoing corneal laser refractive surgery.

Design

randomized, controlled, clinical trial with triple-blinding.

Methods

Setting: Vissum Miranza - Alicante; Study population: 61 patients randomized in two groups: 31 study patients (perioperative IPL + laser refractive surgery) and 30 control patients (perioperative placebo + laser refractive surgery). Follow-up was conducted over a 6-month period; Intervention: Each participants underwent three IPL sessions with a two-week interval between each session (pre-surgery, post-surgery week-one, and post-surgery week-three). For controls, placebo was administered following the same protocol. Main outcomes measures: visual outcomes and refraction, slit-lamp examination, corneal topography, visual analogue scale questionnaire and Oculus Keratograph 5 M including tear meniscus height, non-invasive tear break- up time, ocular redness, infrared meibography and Ocular Surface Disease Index (OSDI) questionnaire.

Results

61 randomized eyes were included. No significant differences were observed in terms of uncorrected and corrected distance visual acuity (UDVA, CDVA), refractive error or corneal aberrations. A statistically significant improvement in OSDI score (change −8.47, p = 0.043), tear meniscus (change 0.05 mm, p = 0.004) and Meibography (change −0.42, p = 0.012) was observed at the third postoperative month in the study group. Additionally, at the sixth postoperative month, there were statistically significant improvements in tear meniscus (change 0.06 mm, p = 0.018), tear break-up-time (change 1.68 s, p = 0.039) and Meibography (change −0.37, p = 0.030).

Conclusions

Results suggest that perioperative IPL therapy applied to laser corneal refractive surgery improves objective and subjective ocular surface parameters over non-IPL-treated control patients and early postoperative dry eye symptoms.