SMILE! A new study that shows IPL works in another group of surgery-induced dry eye!

I’ve written extensively about IPL (Intense Pulsed Light) therapy for dry eye treatment https://www.eyethera.com/search?q=ipl&f_collectionId=5f1772c75adebf1951219a32 and the fact that the FDA approved it for the treatment of dry eye a number of years ago should help convince patients of its usefulness in treating this disease. Now we have yet another study that shows it works - in this case, for those suffering with dry eye after SMILE surgery,

So what is SMILE surgery, you might ask? SMILE (Small Incision Lenticule Extraction) Eye Surgery is an alternative to traditional LASIK surgery, using a laser to correct nearsighted and astigmatism errors otherwise requiring glasses or contact lenses to correct (so-called refractive surgery, as it is surgery to correct errors of refraction like nearsightedness or “myopia".”). Many of you already know the dry eye perils of traditional LASIK surgery (laser-assisted in situ keratomileusis - a means of “burning” the imprint of a contact lens into the surface of the cornea to correct the focus akin to wearing a contact lens without the contact) - and in fact, nearly any eye operation carries some risk of aggravating or causing dry eye (see my post on cataract surgery, which also applies to all refractive surgeries https://www.eyethera.com/blog/dry-eye-cataract-and-glaucoma-segment?rq=cataract). Up to 95% of LASIK patients experience some degree of dry eye disease after the operation, though the duration is usually self-limited, with this number sinking to 60% at one month and 28% by 3 months. SMILE results are similar to traditional LASIK, but has reportedly caused less numbers of dry eye - largely due to the smaller incisions required to correct vision (so cutting through fewer nerves and requiring less healing response). AI came through with the following information: https://www.google.com/search?q=smile+eye+surgery&oq=smile+eye+surgery&gs_lcrp=EgZjaHJvbWUyDAgAEEUYORixAxiABDIKCAEQABiSAxiABDIHCAIQABiABDIKCAMQABjJAxiABDIHCAQQABiABDIHCAUQABiABDIHCAYQABiABDIHCAcQABiABDIHCAgQABiABDIHCAkQABiABNIBCTU5MTVqMGoxNagCCLACAfEFIKDrlacOOaU&sourceid=chrome&ie=UTF-8

Reference
Lai M, Zhong J, Lu Z, et al. Clinical study on the safety and efficacy of intense pulsed light in the treatment of dry eyes after full femtosecond small incision lenticule extraction. Medicine (Baltimore). 2025;104(37):e44161. doi: 10.1097/MD.0000000000044161. PMID: 40958233; PMCID: PMC12440531.

In a summary article in oph-today@ophthalmology360.email last month (reference abvoe), “Intense pulsed light (IPL) therapy is more effective and safer than conventional medication for treating dry eye syndrome after SMILE surgery, with sustained long-term benefits, while diabetes remains a key factor that can worsen outcomes and increase adverse events, according to a study.

Researchers compared IPL treatment with conventional medication in post-SMILE patients, analyzing outcomes over 6 months. The study found that IPL significantly improved key measures of eye health, including ocular surface disease index scores, tear breakup time, Schirmer test results, eye dryness scores, and meibomian gland function. Intense pulsed light also reduced the risk of adverse events compared with conventional therapy. Diabetes emerged as a major factor influencing treatment outcomes, increasing both dry eye severity and the likelihood of complications. However, IPL therapy’s benefits were sustained over time, showing superior long-term efficacy and safety.”

I think that the demand for refractive/vision corrective surgery will continue to exist despite any risks and believe that any technique that proves safer in terms of less dry eye complications but with similar efficacy in correcting vision, is to be lauded. Having a better tool to treat that complication when it inevitably occurs, is even more laudable. Putting another “focus” on IPL is helpful, in large part because it reinforces that current clinical understanding of how it works and broadens this context.

To schedule an appointment with Dr. Jaccoma, call Excellent Vision at either of these two dry eye offices:

(1) 155 Griffin Rd, Portsmouth, NH 03801 (603) 574-2020

(2) 3 Woodland Rd, STE 112 Stoneham, MA 02180 (near Boston) (781) 321-6463