Abstract
BACKGROUND: Dry eye disease is a common ocular condition, affecting quality of life and function for many people worldwide. This systematic review evaluates the effectiveness and safety of intense pulsed light (IPL) therapy for dry eye symptoms due to meibomian gland dysfunction (MGD), as they are not yet established. METHODS: Comprehensive searches were conducted in January 2024 (Cochrane Library, Embase, MEDLINE). We included randomized controlled studies assessing the effects of IPL on dry eye symptoms or any adverse effects in patients with MGD. Two authors independently screened studies and evaluated the risk of bias. Meta-analysis (random effects model) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to synthesize results and assess certainty of evidence. RESULTS: In total, 13 studies were included in the review. The risk of bias was assessed as moderate in most results primarily due to the risk of selective reporting. The synthesis and GRADE assessment show that IPL probably results in a clinically relevant reduction in symptoms of dry eyes when compared to placebo (MD = -16 OSDI points; 95% CI = -20 to -12). However, whether the effect is clinically relevant when used as an add-on to standard care is still unclear (MD = -7 OSDI points; 95% CI = -12 to -3). Furthermore, the evidence on adverse events is very uncertain. CONCLUSION: Although IPL probably results in a clinically relevant reduction in symptoms of dry eyes when compared to placebo, in practice IPL would typically be used as an add-on to standard treatment. It is therefore essential with further studies investigating whether this use would give a clinically relevant reduction in symptoms, and what the potential harm of IPL is when treating MGD.