Technological Interventions for Dry Eye Disease: A Systematic Review and Random-Effects Network Meta-analysis of...

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Medical Technology

Background:

• Dry eye disease (DED) pathophysiology is increasingly targeted by novel therapeutic technologies.
• Emerging modalities aim to address the complex mechanisms underlying DED.

Purpose of the Study:

• To systematically evaluate and compare the efficacy of various technological interventions for DED.
• To rank the effectiveness of different treatments based on objective and subjective outcomes.

Main Methods:

• A systematic review and network meta-analysis of randomized controlled trials (RCTs) from PubMed, Scopus, and Embase.
• Included interventions: intense pulsed light (IPL), thermal pulsation, TearCare, iLux, low-level light therapy (LLLT), transcutaneous electrical stimulation (TES), and quantum molecular resonance (QMR) therapy.
• Evaluated outcomes: tear break-up time (TBUT), Schirmer test, corneal staining, meibomian gland quality, and symptom severity at 2-4 months post-treatment.

Main Results:

• Forty-seven RCTs involving 3581 patients were analyzed.
• TearCare with meibomian gland expression (MGX) and IPL with a heated eye mask (HEM) showed highest TBUT improvement.
• QMR therapy was most effective for corneal staining; TearCare with MGX led in meibomian gland secretion quality.
• IPL-based modalities, particularly IPL plus HEM, demonstrated superior symptom relief.

Conclusions:

• TearCare with MGX and IPL-based protocols offer superior efficacy for DED outcomes at 2-4 months.
• These technologies outperform other interventions and conservative treatments.
• Further standardized, long-term comparative studies are necessary to confirm findings.