ESCRS - POCOR461 - Tear Biomarker Changes And Ocular Surface Recovery With Low-Level Light Therapy After Cataract Surgery: A Double-Masked Randomized Controlled Clinical Trial

Tear Biomarker Changes And Ocular Surface Recovery With Low-Level Light Therapy After Cataract Surgery: A Double-Masked Randomized Controlled Clinical Trial

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR461 | Type: Free paper | DOI: 10.82333/raba-xx45

Authors: Prof. Dr Giuseppe Giannaccare* 1 , Dr Mihaela-Madalina Timofte-Zorila 2 , Prof. Dr Mariana Pavel-Tanasa 2 , Dr Nicoleta Vlas 3 , Dr Filippo Lixi 1 , Dr Mario Troisi 4 , Dr Daniela Constantinescu 2 , Dr Radu Tanasa 5 , Dr Diana Alecu 2 , Dr Sabina Turcas 2 , Dr Sinziana Istrate 6 , Dr Daciana Elena Branisteanu 3 , Dr Cristina Preda 2 , Prof. Dr Daniel Constantin Branisteanu 2

1Department of Surgical Sciences,University of Cagliari,Cagliari,Italy, 2University of Medicine and Pharmacy,Iasi,Romania, 3University of Medicine and Pharmacy,Iasi,Italy, 4Federico II University,Naples,Italy, 5Alexandru Ioan Cuza University,Iasi,Romania, 6Carol Davila University of Medicine and Pharmacy,Bucharest,Romania

Purpose

This study aimed at evaluating the perioperative effects of LLLT on ocular surface modulation by correlating clinical outcomes with tear biomarker dynamics and developing predictive models to identify patients most likely to benefit from LLLT.

Setting

A prospective, double-masked randomized clinical, sham-controlled study conducted at the “Cai Ferate” Clinical Hospital in Iasi, Romania between January and March 2025.

Methods

Eighty-eight patients undergoing cataract surgery were randomized to receive LLLT (n=44) or sham treatment (n=44). Clinical evaluation—including Ocular Surface Disease Index questionnaire, tear breakup time, Schirmer test, and tear osmolarity—was performed preoperatively and one month postoperatively to classify patients in subclinical or clinical DED. Tear levels of biomarkers involved in tissue repair and neurotrophic-signaling (GDF-15,β-NGF,VEGFA,PDGF-AB,PDGF-CC) and inflammation (OPN,OPG,TNF-α) were quantified using Luminex FlexMap3D technology.

Results

LLLT-treated patients showed significantly greater clinical improvement compared to sham controls (44.2% vs. 4.4%; p<0.0001). LLLT significantly increased GDF-15 (from 77.6±7.2 to 95.5±7.4 pg/mL; p=0.0112) and PDGF-CC (from 711.4±76.6 to 1024±130.8 pg/mL; p=0.0473), particularly in patients with baseline DED, while β-NGF increased mainly in borderline patients (10.1±3.0 vs. 5.8±0.55 pg/mL; p=0.0271). Inflammatory biomarker profiles indicated resolution in the LLLT group, whereas sham-treated patients showed persistent inflammatory patterns. Predictive models integrating clinical and molecular data demonstrated excellent performance, with adjusted AUC values up to 0.977.

Conclusions

LLLT promotes ocular surface recovery after cataract surgery by modulating reparative, neurotrophic, and inflammatory pathways. Tear biomarkers (GDF-15, β-NGF, PDGF-CC) combined with clinical parameters may help predict treatment response and guide personalized DED management.