Low-level Laser Therapy Improves Refractive Surgery Outcomes

Small IPL ‘Intense Pulsed Light’ laser hair removal device for usage at home on white table in front of gray background
Low-level laser therapy, with or without intense pulse light therapy, showed improvements without adverse events.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 meeting of American Society of Cataract and Refractive Surgery (ASCRS), held in Las Vegas from July 23 to 27, 2021. The team at Ophthalmology Advisor will be reporting on a variety of research presented by the cataract and refractive surgery experts at ASCRS. Check back for more from the ASCRS 2021 Meeting.


Low-level laser therapy (LLLT), with or without intense pulse light therapy (IPL), is an effective adjunctive therapy for patients with severe meibomian gland dysfunction (MGD) before they undergo refractive surgery. Karl G. Stonecipher, MD, ABO, Medical Director of TLC Laser Eye Centers Greensboro and a professor at University of North Carolina School of Medicine, presented his research at the 2021 American Society of Cataract and Refractive Surgery (ASCRS) meeting, held in Las Vegas July 23 to July 27.

In the prospective study of IPL/LLLT vs LLLT for treatment of MGD, Stonecipher treated 526 eyes of 263 cataract and refractive patients who had previously undergone treatment with topical and systemic medications without success.

The researcher evaluated the intervention using the ocular surface disease index (OSDI), the meibomian gland expression (MGE), and tear break up time (TBUT), comparing the measures seen in the eyes prior to treatment and 1 to 3 months after the treatment. Follow-up with patients occurred up to 1 year after treatment.

Average OSDI score prior to the IPL/LLLT intervention was 44.4 and average MGE was 3.63 out of 4, with 4 being the inability to express meibum and 0 being normal. After the treatment, the average OSDI was 25.4 and MGE was 2.36. TBUT prior to treatment was 3.78 seconds, and it increased to 7.56 seconds after treatment.

The LLLT only group experienced significant improvements in mean OSDI score (P =.002), MGD grading (P <.001), TBUT (P <.001). Nasal and temporal lissamine green staining (P <.02) were present.

Thirty-six of 50 eyes had an MGD grade reduction greater than 1.

All patients reported improvement following treatment, without adverse events.

“The use of IPL/LLLT or LLLT alone for the treatment of MGD is beneficial in patients who have failed topical and/or systemic therapy,” according to the investigator.

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Stonecipher KG. Treatment of meibomian gland dysfunction (MGD) with intense pulse light therapy(IPL) with low level light therapy (LLLT) versus LLLT alone. Paper presented at: American Society of Cataract and Refractive Surgery (ASCRS) 2021 Annual Meeting; July 12-27; Las Vegas, Nevada. Paper 72811.