Journal Article

Outcomes of low-level light therapy before and after cataract surgery for the prophylaxis of postoperative dry eye: a prospective randomised double-masked controlled clinical trial

Carnovale Scalzo, Giovanna, Giannaccare, Giuseppe, Borselli, Massimiliano, Rossi, Costanza, Scalia, Giovanni, Fratto, Benedetta, Scorcia, Vincenzo, Yu, Angeli Christy, Pellegrini, Marco, Pietropaolo, Rocco

2024

Overview

BackgroundDespite increasing evidence shows that optimising ocular surface before cataract surgery is fundamental in patients with pre-existing dry eye disease (DED) to achieve the desired postoperative outcomes, the prophylactic treatment of healthy patients undergoing surgery aiming at preventing iatrogenic DED is worth investigating.MethodsThis was a prospective, interventional, randomised, controlled, double-masked clinical trial. Patients were randomly assigned 1:1 to receive either low-level light therapy (LLLT) or sham treatment (LLLT with a power output <30%). Patients underwent two treatment sessions: 7±2 days before cataract surgery (T0) and 7±2 days after (T1). Outcome measures evaluated 30±4 days after surgery (T2) included Ocular Surface Disease Index (OSDI) questionnaire, non-invasive break-up time (NIBUT), tear meniscus height, meibomian gland loss (MGL) and redness score.ResultsOut of 153 patients randomised to receive LLLT (n=73) or sham treatment (n=80), 131 (70 men, 61 women, mean age 73.53±7.29 years) completed regularly the study. Patients treated with LLLT had significantly lower OSDI scores compared with controls at T1 and T2 (respectively, 7.2±8.8 vs 14.8±13.0 and 9.0±9.0 vs 18.2±17.9; both p<0.001), higher NIBUT values at T2 (12.5±6.6 vs 9.0±7.8; p=0.007) and lower MGL Meiboscore values at T1 (1.59±0.70 vs 1.26±0.69; p=0.008). Unlike controls, patients treated with LLLT had significantly lower OSDI scores and higher NIBUT values at T2 compared with T0 (respectively, 9.0±9.0 vs 21.2±16.1; p<0.001 and 12.5±6.6 vs 9.7±7.2; p=0.007).ConclusionTwo sessions of LLLT performed before and after cataract surgery were effective in ameliorating tear film stability and ocular discomfort symptoms.Trial registration numberNCT05754437.

• Publisher: BMJ Publishing Group Ltd,BMJ Publishing Group LTD
• Subject: Aged / Aged, 80 and over / Cataract Extraction / Cataracts / Clinical science / clinical trial / Clinical trials / Disease prevention / Double-Blind Method / Dry Eye Syndromes - etiology / Dry Eye Syndromes - prevention & control / Eye diseases / Eye surgery / Female / Hormone replacement therapy / Humans / Iatrogenesis / Light / Light therapy / Low-Level Light Therapy - methods / Male / Middle Aged / ocular surface / Ophthalmology / Patient satisfaction / Phacoemulsification / Postoperative Care - methods / Postoperative Complications - prevention & control / Postoperative period / Preoperative Care - methods / Prospective Studies / Statistical analysis / Surveys and Questionnaires / tears / Tears - metabolism / treatment other / Treatment Outcome / treatment surgery / Variance analysis