Corneal Morphology Changes After Intense Pulsed Light Therapy In Dry Eye Disease

To study corneal epithelial and stromal morphological changes after treatment with intense pulsed light (IPL) in patients with Dry Eye Disease (DED).

Centro Hospitalar Universitário de Santo António, Unidade Local de Saúde de Santo António, Oporto, Portugal

We conducted a prospective study set at the outpatient clinic of a tertiary hospital. Adult patients with clinical diagnosis of DED undergoing IPL treatment (E>Eye® by ESW vision, France) were eligible for participation. Each patient underwent swept-source optical coherence tomography (OCT) corneal epithelial thickness mapping (Anterion®, Heidelberg Engineering, Germany) and automated ocular surface analysis (IDRA® Ocular Surface Analyzer SBM Sistemi, Italy) before and 1 month after IPL treatment. Schirmer’s test, tear film osmolarity (TearLab® Osmolarity System) and a validated DED-related questionnaire (OSDI-12) were also evaluated.

This study enrolled 106 eyes of 53 subjects, with a mean age of 56.6 ± 16.6 years. After treatment, statistically significant differences were observed for the Oxford score (Δ-0.3 ±1.31, p=0.029), eye blink (Δ19.4 ±25.1, p<0.001), lipid layer thickness (Δ-2.3 ±25.3, p=0.016), infrared meibography (Δ3.1 ±19.7, p=0.027) and OSDI-12 score (Δ-156 ±25.5, p<0.001).

After IPL treatment, there was significant increase in mean stromal thickness (Δ+1.8 μm, p=0.009) and across several areas. There were no significant differences regarding epithelial thickness across any area.

Our study is pioneer in studying corneal morphological changes in patients with DED treated with IPL therapy. Its modulating properties may enhance stromal remodeling and promote its rearrangement. Regional analysis revealed no morphological changes regarding epithelial thickness before and after treatment.