Effects of Intense Pulsed Light Treatment Combined with Meibomian Gland Expression on Post-Laser Corneal Refractive Surgery Dry Eyes.

PURPOSE: Refractive surgery may exacerbate the existing dry eye symptoms in patients with dry eye syndrome. Therefore, we explore the therapeutic and protective effects of using optimal intense pulsed light (IPL) therapy combined with meibomian gland expression (MGX) before and after surgery on post-laser corneal refractive surgery dry eyes.

METHODS

This was a prospective, self-controlled, single-center clinical trial. Using optimal IPL therapy and MGX, a total of 68 patients with mild-to-moderate evaporative dry eye or meibomian gland dysfunction who underwent refractive surgery received 2 sessions of treatment. The treatment was administered once a week preoperatively and once a week postoperatively. Baseline measurements were taken before optimal IPL therapy and MGX, and the parameters were assessed at 1 week and 1 month after surgery.

RESULTS

Out of 68 patients, 54 patients received small-incision lenticule extraction (SMILE), while 14 patients received femtosecond laser-assisted in situ keratomileusis (FS-LASIK) (results primarily reflect SMILE outcomes due to sample imbalance). In the SMILE group, significant improvement was already observed in uncorrected/corrected distance visual acuity (P = 1.42 × 10-3), meibomian gland expressibility score (MGYSS) (P = 0.01), and meibum yielding secretion score (MGS) (P = 5.39 × 10-4) between 1 week before and after the surgery. First noninvasive breakup time (NIBUTf) (P = 8.98 × 10-3), average noninvasive breakup time (NIBUTav) (P = 2.30 × 10-4), and meibomian gland dropout score (bottom) (P = 9.05 × 10-3) were observed to have significant improvement till 1 month after the surgery. Patients in the FS-LASIK group exhibited a comparable trend of change.

CONCLUSION

IPL treatment combined with MGX may improve ocular discomfort and dry eye symptoms in MGYSS, MGS, NIBUTf, NIBUTav, and meibomian gland dropout score (bottom) for patients with post-laser corneal refractive surgery dry eyes in short term.