Clinical study on the safety and efficacy of intense pulsed light in the treatment of dry eyes after full femtosecond small incision lenticule extraction

Dry eye syndrome is a common postoperative complication following small incision lenticule extraction (SMILE) surgery that significantly impacts patients' quality of life. Intense pulsed light (IPL) therapy is widely used for managing dry eye syndrome, but its efficacy and safety warrant further evaluation. This study first analyzed baseline characteristics of patients with dry eye syndrome after SMILE surgery, comparing differences between the conventional medication group and the IPL treatment group. Multivariable linear regression was then used to assess the effects of IPL treatment and baseline factors on dry eye indicators 6 months posttreatment. To minimize selection bias, inverse probability of treatment weighting was applied. Furthermore, multivariable logistic regression evaluated the impact of IPL on adverse event occurrence, while generalized estimating equations assessed IPL efficacy at multiple time points. Multivariable linear regression revealed that diabetes and prolonged screen time were associated with increased ocular surface disease index (OSDI) scores, while IPL treatment significantly reduced OSDI scores (P < .05). Diabetes correlated with decreased tear breakup time and Schirmer test results, whereas IPL improved these measures. For eye dryness scores and meibomian gland scores, diabetes showed a positive association, but IPL treatment significantly decreased both. After inverse probability of treatment weighting adjustment, the effects of screen time and diabetes on OSDI and Schirmer test values lost statistical significance. Multivariable logistic regression demonstrated that diabetes increased the risk of adverse events by 14.2%, while IPL treatment reduced this risk to 7%. Generalized estimating equations analysis indicated that IPL efficacy improved significantly over time, with marked long-term benefits. IPL therapy offers superior efficacy and safety compared to conventional medication in treating dry eye syndrome after SMILE surgery, particularly in the long term. Diabetes remains a key factor affecting treatment outcomes and adverse event rates in this population.