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Publications

Journal Article Review Ahead of print

PubMed: 42860563 DOI: 10.1111/aos.70252

Low-level light therapy for dry eye disease and meibomian gland dysfunction: A systematic review and meta-analysis.

Acta Ophthalmol

Authors: Sjur Reppe, Yousif Subhi, Tore Steinkjer, Mazyar Yazdani, Miriam Kolko, Tor P Utheim, Fredrik Andreas Fineide

Affiliations

  • Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway.
  • Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
  • Department of Ophthalmology, University Hospital of Southern Denmark, Sønderborg, Denmark.
  • Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
  • Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway. The Norwegian Dry Eye Clinic, Oslo, Norway.
  • Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
  • Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.
  • Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark.
  • Eye Hospital Your Eye Doctors, Rungsted Kyst, Denmark.
  • The Norwegian Dry Eye Clinic, Oslo, Norway.
  • Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.
  • Department of Quality and Health Technology, The Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
  • Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway.
  • Department of Ophthalmology, Stavanger University Hospital, Oslo, Norway.
  • Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway.
  • Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway.
  • Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
  • Department of Research and Development, Oslo Metropolitan University, Oslo, Norway.
  • Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
  • Department of Optometry, Radiography and Lighting Design, Faculty of Health Sciences, National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway.
  • Department of Maxillofacial Surgery, Oslo University Hospital, Oslo, Norway.
  • Department of Ophthalmology, Faculty of Life Course Sciences and Medicine, King's College London, London, UK.
  • Department of Ophthalmology, Østfold Hospital Trust, Moss, Norway.
  • Department of Computer Science, Oslo Metropolitan University, Oslo, Norway.

Abstract

A healthy tear film is vital for ocular surface integrity and relies on the coordinated function of the lacrimal glands, meibomian glands and conjunctival goblet cells. Dysfunction in any of these elements can lead to dry eye disease (DED). This systematic review and meta-analysis evaluated the efficacy of low-level light therapy (LLLT) as a standalone DED treatment. Although evidence for LLLT's therapeutic potential is growing, prior reviews have focused on short-term outcomes or combined LLLT with intense pulsed light. This meta-analysis consolidates current findings to clarify the clinical value of LLLT monotherapy in DED management. We systematically searched MEDLINE, Embase, Scopus and the Cochrane Central Register of Controlled Trials for studies evaluating LLLT for DED. Study selection and data extraction were conducted according to pre-specified inclusion and exclusion criteria. Meta-analyses were performed for Ocular Surface Disease Index (OSDI), non-invasive break-up time (NIBUT) and tear meniscus height (TMH). Ten clinical studies were eligible for our systematic review, which included a total of 473 participants. Irradiation protocols included treatment sessions using wavelengths of 625-640 nm and/or 810-850 nm, with each session lasting a minimum of 10 min. In our meta-analyses, LLLT monotherapy was associated with significant improvements in OSDI (weighted mean difference [WMD] -11.42, p < 0.00001), NIBUT (WMD +1.49 s, p = 0.005), and TMH (WMD +0.04 mm, p = 0.007). Sensitivity analyses restricted to eligible RCTs confirmed significant effects on OSDI and NIBUT, but not on TMH. No adverse events were reported. LLLT appears to be well tolerated and may improve signs and symptoms of DED, particularly ocular discomfort. It may represent a promising standalone treatment option for patients in whom combination regimens involving IPL treatment are contraindicated.

MeSH

Tears, Signs And Symptoms, Phototherapy, Eye Diseases, Therapeutics, Meibomian Glands, Dry Eye Syndromes, Meibomian Gland Dysfunction, Low-Level Light Therapy