Effects of Intense Pulsed Light Treatment on Dry Eye Disease After Keratorefractive Surgery: A Retrospective Cohort Study

TL;DR

This study found that IPL treatment for dry eye disease is less effective in people who previously had keratorefractive surgery compared to those who did not.

Contribution

The study is the first to compare IPL treatment outcomes for dry eye disease in individuals with and without prior keratorefractive surgery.

Findings

Non-KRS individuals showed significantly better improvement in tear break-up time after IPL treatment.

KRS individuals had more risk factors for poor IPL treatment outcomes, including low tear meniscus height and high ocular surface staining.

DED symptoms improved more in non-KRS individuals compared to those with prior KRS.

Abstract

Purpose: This study aimed to evaluate the therapeutic outcome of intense pulsed light (IPL) treatment in individuals with dry eye disease (DED) who received previous keratorefractive surgery (KRS).

Methods: A retrospective cohort study was conducted, and individuals who received IPL treatment were enrolled. Then, the individuals were categorized according to whether they underwent KRS, with a total of 11 and 35 eyes enrolled in the KRS and non-KRS groups, respectively. The primary outcomes were non-invasive tear break-up time (NITBUT), the Schirmer I test, ocular surface staining, and DED symptoms. A generalized linear model was used to evaluate the difference in treatment outcomes between the two groups.

Results: Six months after the IPL treatment, the post-treatment NITBUT was significantly higher in the non-KRS group than the KRS group (P < 0.001). Regarding the trend of DED improvement, NITBUT (P < 0.001) and ocular surface staining (P = 0.001) presented a better improvement in the non-KRS group. In regard to pre-treatment risk factors for poor response after IPL treatment, low NITBUT, low TMH, high ocular surface staining, and multiple DED-related symptoms correlated to poor treatment outcome in the KRS population (all P < 0.05). On the other hand, low NITBUT and high ocular surface staining were associated with poor treatment outcome in the non-KRS population (both P < 0.05).

Conclusions: Individuals with DED that previously underwent KRS presented a lower NITBUT and ocular surface staining recovery after IPL treatment compared to the non-KRS DED individuals, and KRS individuals have more risk factors for poor outcomes after IPL. Alternative DED treatment may be considered for the population with previous KRS.