Intense Pulse Light for Treating Post-LASIK Refractory Dry Eye

Objective: Optimal pulse technology-intense pulse light (OPT-IPL) treatment on patients with post-LASIK refractory dry eye (DE). Background: The prevalence of dry eye disease is common and can lead to ocular discomfort, reduced visual acuity, lowered quality of vision and life. Materials and methods: A prospective study was conducted on 72 eyes of 36 patients (treatment group, n = 42 eyes; control group, n = 30 eyes) who had previously undergone myopic LASIK correction with subsequent refractory DE. All eyes fulfilled the Japanese DE criteria and had not responded to conventional DE treatment. The treatment group underwent two OPT-IPL treatment sessions at 2-week intervals, while the control group received no treatment. Best-corrected visual acuity (BCVA), ocular surface disease index (OSDI), noninvasive breakup time (NITBUT), tear film lipid layer (TFLL) quality, corneal fluorescein staining, meibum gland (MG), endothelial cell count (ECC), and intraocular pressure (IOP) were assessed at baseline (D0), day-14 (D14) and day-28(D28) after OPT-IPL treatment. Results: The mean age of treatment group and control group was 30.48 +/- 5.16 years (12 females, 57%) and 31.00 +/- 4.33 years (8 females, 53%), respectively. Treatment group had clinically and statistically significant improvement in NITBUT and was observed at D14 (p < 0.001) and D28 (p < 0.001). OSDI, TFLL score, and MG quality and expressibility improved significantly (p < 0.05) at D28, whereas BCVA, ECC, and IOP showed no significant changes at D14 and D28 between the groups. Conclusions: Our results suggest that post-LASIK refractory DE is safely treated with OPT-IPL treatment. OPT-IPL treatment reduced the severity of symptoms and improved the overall tear film stability in patients with severe refractory DE post-LASIK surgery. In addition, the frequency of artificial tears usage was significantly less and can be attributed to the reduction in OSDI scores due to improved TFLL and tear film stability.