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Intense Pulse Light Combined With Low-Level Light Therapy in Dry Eye Disease: A Systematic Review

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ICL.0000000000000958

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Intense pulse light; Low-level light therapy; Meibomian gland dysfunction; Dry eye disease

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The combination of intense pulse light (IPL) and low-level light therapy (LLLT) shows improvement in symptoms and signs of dry eye disease (DED). Results from relevant studies indicate that this treatment decreases the Ocular Surface Disease Index (OSDI) score, meibomian gland dysfunction (MGD) score, MGD grade, and meiboscore, while increasing tear film stability, lipid layer thickness, and loss area of the meibomian gland. However, the effects on tear volume, tear meniscus height, and Schirmer test are inconclusive.
Objectives:To evaluate the improvement in symptoms and signs associated with intense pulse light (IPL) combined with low-level light therapy (LLLT) in the treatment of dry eye disease (DED).Methods:A systematic review of full-length original studies reporting the effects of IPL combined with LLLT for DED in two databases, PubMed and Scopus, was performed according to the PRISMA statement. The quality assessment tool for case series studies from the National Heart, Lung, and Blood Institute was used to analyze the quality of the studies selected.Results:The search provided a total of 393 articles, of which six were included. Significant decreases in the Ocular Surface Disease Index (OSDI) score, meibomian gland dysfunction (MGD) score, MGD grade, and meiboscore and increases in tear film stability, lipid layer thickness, and loss area of the meibomian gland have been reported. Concerning tear volume, tear meniscus height, and Schirmer test remained unchanged. In relation to tear osmolarity and corneal fluorescein staining, contradictory outcomes were found.Conclusions:Intense pulse light combined with LLLT for the treatment of dry eye improves OSDI, tear film stability, and meibomian gland function; thus, this treatment may be recommended for DED patients due to MGD.

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