Low-Level Light Therapy One Week Before And After Cataract Surgery For Preventing Iatrogenic Dry Eye: Results From A Prospective, Randomized Controlled Study

To assess the effectiveness of Low-Level Light Therapy (LLLT) in preventing iatrogenic dry eye disease (DED) in otherwise healthy patients undergoing senile cataract surgery.

Department of Ophthalmology, University Magna Graecia of Catanzaro, Italy.

Prospective, single-center randomized controlled trial conducted on healthy patients undergoing senile cataract surgery. Enrolled patients were randomly assigned to either a treatment group (group A receiving a LLLT session 1 week before [T0] and 1 week after surgery [T1] with Meibomask, [Espansione Marketing S.p.A., Bologna, Italy] or a control group (group B). Before any procedure and 1 month after surgery (T2), all patients were assessed by means of Oculus Keratograph 5M (Oculus GmbH, Wetzlar, Germany) to measure: tear meniscus height (TMH), bulbar redness, noninvasive break-up time (NIBUT) and infrared meibography of the lower eyelid. Ocular discomfort symptoms were assessed using the ocular surface disease index (OSDI) questionnaire.

Data from 109 patients were included (mean age 73.45 years, range 47-89). Of these, 63 patients belonged to group A while 46 to group B. The two groups had similar baseline characteristics for all investigated parameters (p > 0.05). At T2, patients of group A showed statistically significant improvement in all parameters except for bulbar redness and infrared meibography. In detail, median values of NIBUT and TMH improved respectively from 4.01 to 6.12 seconds (p=0.02) and from 0.30 to 0.33 millimeters (p = 0.04), while median value of OSDI score decreased from 19.0 to 6.0 (p < 0.0001). Conversely, no significant differences were found for all parameters in group B.

It was recently demonstrated that LLLT is a non-invasive, well-tolerated treatment able to improve DED signs and symptoms. It is well known that even uneventful cataract surgery can induce or worsen DED. Our findings demonstrate that otherwise healthy patients undergoing senile cataract surgery can improve ocular surface status avoiding the occurrence of iatrogenic DED by receiving 2 sessions of LLLT, 1 week before and after surgery.