Intense Pulsed Light Therapy for Post-LASIK Dry Eye: A Systematic Review and Meta-Analysis

Abstract

Purpose:

To assess the efficacy and safety of intense pulsed light (IPL) therapy in managing dry eye syndrome (DES) following laser-assisted in situ keratomileusis (LASIK) surgery through a systematic review and meta-analysis.

Methods:

A comprehensive literature search was conducted across PubMed, Embase, Cochrane, Web of Science, and ClinicalTrials.gov for studies reporting outcomes of IPL treatment in post-LASIK DES. Eligible studies included randomized controlled trials, observational studies with control groups, and retrospective or prospective chart reviews. Outcomes analyzed included tear breakup time (TBUT), Ocular Surface Disease Index (OSDI) score, artificial tear use (ATU), corneal staining, lipid layer thickness, and meibomian gland function. Analyses were restricted to pre-post single-arm comparisons. Random-effects meta-analyses were conducted using inverse-variance weighting with DerSimonian-Laird estimation and Hartung-Knapp-Sidik-Jonkman adjustment. Heterogeneity was assessed using I² and τ² statistics, and design-effect corrections were applied for eye-level clustering.

Results:

Four studies met inclusion criteria, comprising 146 treated eyes. IPL was associated with a significant improvement in patient-reported symptoms measured by OSDI (P = 0.005). Improvements in TBUT, ATU, corneal staining, lipid layer thickness, and meibomian gland function were directionally favorable but did not reach statistical significance after conservative correction. Between-study heterogeneity was substantial, and follow-up duration was limited (0–24 weeks).

Conclusion:

IPL therapy may improve subjective dry eye symptoms following LASIK, while objective clinical outcomes remain uncertain. Current evidence remains limited, underscoring the need for larger, controlled studies with standardized protocols and longer follow-up to further define IPL’s role in managing post-surgical dry eye.