Outcomes Of Low-Level Light Therapy In Glaucoma Patients Suffering From Drug-Induced Iatrogenic Ocular Surface Disease

Topical glaucoma medications can cause ocular surface disease (OSD) due to their toxic effects on the ocular surface, affecting patient adherence to therapy. Low-level light therapy (LLLT) (or photobiomodulation) has been shown to be an effective treatment for dry eye. This study aims to investigate the efficacy of LLLT in glaucoma patients with signs and symptoms of OSD.

Prospective, randomized, multicenter clinical study

Primary open-angle glaucoma (POAG) patients under IOP-lowering drugs were randomized 1:1 to receive (group 1) LLLT using the Eye-Light^® mask (Espansione Marketing S.p.A, Bologna, Italy) with the red light for 15 min with eyes closed or (group 2) sham treatment. All participants received 6 mask sessions 2 times a week for 3 wk. Topical medications were maintained unchanged during the study. Outcomes were evaluated before starting study treatment (T0) and 4 wk after the last treatment session (T1) for the evaluation of: Ocular Surface Disease Index (OSDI) questionnaire, tear breakup time (BUT), Schirmer test, corneal fluorescein staining (CFS) (Oxford Scale), intraocular pressure (IOP), Glaucoma Symptoms Scale (GSS) and compliance.

Thirty participants (males=22, females=8; mean age 72.53±11.32 years) completed the study. In group 1, LLLT resulted in a statistically significant improvement in BUT, Schirmer test, CFS, MGD, GSS and OSDI score (respectively, from 3.05±0.51 to 4.05±0.89 s, p=0.05; from 6.70±1.84 to 7.30±1.66 mm/5’, p=0.049; CFS from 2.00±2.42 to 1.05±0.37, p=0.024; GSS from 59.46±16.23 to 72.72±14.91, p=0.034; OSDI from 42.24±13.76 to 29.11±14.69, p=0.025). No statistically significant results were detected in control group for all outcomes. IOP did not change significantly after treatment in both groups.

LLLT is a non-invasive, well-tolerated treatment that reduces signs and symptoms in patients with iatrogenic OSD owing to glaucoma medication.