Corneal epithelium remodelling after Laser refractive surgery with perioperative intense pulsed light treatment

Abstract

Purpose

To evaluate the impact of perioperative Intense Pulsed Light (IPL) therapy on corneal epithelial remodeling and epithelial refractive stability in patients undergoing femtosecond laser-assisted in situ keratomileusis (FS-LASIK) or keratorefractive lenticule extraction (KLEx).

Methods

This randomized, controlled, triple-masked clinical trial included 61 patients assigned to either IPL treatment or a placebo prior to and following refractive surgery. Epithelial thickness (ET), epithelial refractive power (Epi-Rx), and Epithelial Wavefront (Epi-WF) were analyzed using anterior segment optical coherence tomography (AS-OCT) and Placido disc-based topography over a six-month follow-up.

Results

Both groups exhibited significant postoperative epithelial thickening, primarily within the first month. While IPL-treated eyes showed trends toward slightly lower ET and more gradual Epi-Rx changes, including a late hyperopic shift and progressive cylinder adaptation, differences between groups were not statistically significant. Epi-WF values remained <0.5 in both cohorts.

Conclusion

Perioperative IPL improved ocular surface parameters in prior analyses but did not significantly alter corneal epithelial remodeling or refractive stability in this cohort. Observed trends suggest potential benefits for epithelial adaptation and ocular surface stability, warranting further investigation with larger sample sizes and longer follow-up.