Dry Eye Disease Management Via Technological Methods: A Systematic Review and Network Meta-analysis

Area of Science:

• Ophthalmology
• Medical Technology
• Clinical Research

Background:

• Dry eye disease (DED) pathophysiology is increasingly targeted by novel technological therapeutic modalities.
• Existing research highlights a growing interest in advanced treatments for DED management.

Purpose of the Study:

• To systematically evaluate and compare the efficacy of various technological interventions for dry eye disease (DED).
• To identify the most effective technological treatments for improving key DED outcome measures.

Main Methods:

• A systematic literature search was performed across PubMed, Scopus, and Embase databases up to July 29, 2023.
• Randomized controlled trials (RCTs) examining intense pulsed light (IPL), LipiFlow, TearCare, iLux, low-level light therapy (LLLT), and acupuncture for DED were included.
• A network meta-analysis was conducted to compare treatment efficacy based on standardized mean differences (SMDs) and P-scores.

Main Results:

• Forty-five RCTs involving 3455 patients were analyzed.
• TearCare combined with meibomian gland expression (MGX) showed the highest efficacy in improving meibomian gland secretion.
• Intense pulsed light (IPL)-based treatments, particularly IPL alone, demonstrated significant improvements in tear break-up time (TBUT) and symptom scores, ranking highest for symptom relief.
• Acupuncture was superior to conservative treatments for increasing tear secretion (Schirmer test values).
• LipiFlow showed modest improvements but was not significantly superior to other evaluated technologies.

Conclusions:

• Advanced technological interventions show significant potential for the short-term management of dry eye disease (DED).
• The study highlights the need for standardized, long-term comparative research to further validate these findings and establish optimal treatment protocols.