Pazo Emmanuel Eric, Huang He, Fan Qingxia, Zhang Can, Yue You, Yang Lanting, Xu Ling, Moore Jonathan Edward, He Wei
He Eye Specialist Hospital, Shenyang, China.
Cathedral Eye Clinic, Belfast, United Kingdom.
Photobiomodul Photomed Laser Surg. 2021 Mar;39(3):155-163. doi: 10.1089/photob.2020.4931. Epub 2020 Dec 8.
Optimal pulse technology-intense pulse light (OPT-IPL) treatment on patients with post-LASIK refractory dry eye (DE). The prevalence of dry eye disease is common and can lead to ocular discomfort, reduced visual acuity, lowered quality of vision and life. A prospective study was conducted on 72 eyes of 36 patients (treatment group, = 42 eyes; control group, = 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. 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 ( < 0.001) and D28 ( < 0.001). OSDI, TFLL score, and MG quality and expressibility improved significantly ( < 0.05) at D28, whereas BCVA, ECC, and IOP showed no significant changes at D14 and D28 between the groups. 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.
优化脉冲技术——强脉冲光（OPT-IPL）治疗准分子激光原位角膜磨镶术（LASIK）后难治性干眼（DE）患者。干眼疾病很常见，可导致眼部不适、视力下降、视觉质量和生活质量降低。对36例患者的72只眼进行了一项前瞻性研究（治疗组，42只眼；对照组，30只眼），这些患者之前接受过近视LASIK矫正，随后出现难治性DE。所有眼睛均符合日本干眼标准，且对传统干眼治疗无反应。治疗组每隔2周进行两次OPT-IPL治疗，而对照组不接受治疗。在OPT-IPL治疗后的基线（D0）、第14天（D14）和第28天（D28）评估最佳矫正视力（BCVA）、眼表疾病指数（OSDI）、非侵入性泪膜破裂时间（NITBUT）、泪膜脂质层（TFLL）质量、角膜荧光素染色、睑板腺（MG）、内皮细胞计数（ECC）和眼压（IOP）。治疗组和对照组的平均年龄分别为30.48±5.16岁（12名女性，57%）和31.00±4.33岁（8名女性，53%）。治疗组的NITBUT在临床和统计学上有显著改善，在D14（<0.001）和D28（<0.001）时观察到。OSDI、TFLL评分以及MG质量和排出能力在D28时显著改善（<0.05），而两组之间的BCVA、ECC和IOP在D14和D28时无显著变化。我们的结果表明，OPT-IPL治疗可安全治疗LASIK后难治性DE。OPT-IPL治疗降低了症状的严重程度，改善了LASIK术后严重难治性DE患者的整体泪膜稳定性。此外，人工泪液的使用频率显著降低，这可归因于TFLL和泪膜稳定性改善导致的OSDI评分降低。
