Table 7.
Summary of studies evaluating LipiFlow in patients undergoing refractive surgery
| Author/design/country | Patients (eyes)/mean age (SD) | Last FU | Study arms | MG function Mean (SD) |
Patient-reported outcomes Mean (SD) |
NITBUT/TBUT Mean (SD) |
Staining | Overall conclusion and safety | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pre | Post | Pre | Post | Pre | Post | Pre | Post | |||||
|
Shetty 2023 [71] Prospective interventional India |
N = 59 patients with mild-to-moderate evaporative DED and/or MGD undergoing refractive surgery, LF pre-LASIK: N = 32 patients (64 eyes), 28 (5) years; LF post-LASIK: N = 27 patients (52 eyes), 27 (5) years |
3 months |
Single 12-min LF Tx pre-LASIK CL: Single 12-min LF Tx 3 months post-LASIK |
NR | NR |
OSDI LF pre-LASIK group preop: 18.0 (2.2) LF post-LASIK group preop: 4.5 (0.9) |
OSDI LF pre-LASIK group postop: 9.5 (1.6)* LF post-LASIK group pre-LF postop: 35.2 (2.3)* LF post-LASIK group post-LF & postop: 17.4 (2.6)*† |
TBUT LF pre-LASIK group preop: 6.9 (0.2) LF post-LASIK group preop: 8.0 (0.1) |
TBUT LF pre-LASIK group postop: 8.3 (0.2)* LF post-LASIK group pre-LF postop: 7.0 (1.5)* LF post-LASIK group post-LF & postop: 9.4 (0.2)*† |
NR | NR |
LF Tx prior to refractive surgery can help lessen the clinical effects of dry eyes after refractive surgery. Safety NR |
|
Schallhorn 2017 [72] Retrospective United Kingdom |
N = 57 patients with dry eye post-LASIK or PRK (109 eyes), 49 years | Various: FU reported under each outcome |
Single 12-min LF Tx Note: LF Tx mean 40.5 months after LASIK/PRK |
MGD Grade Score NR Note: graded 0–4 |
MGD Grade Score LF: Change from BL: − 0.69* Note: BL is pre-LF but post-LASIK/PRK |
SPEED II LF: 17.5 |
SPEED II LF: 10.2* Note: FU mean 25 days |
TBUT LF: 3.7 Note: value pre-LF but post-LASIK/PRK |
TBUT LF: 5.75* Note: FU mean 89 days |
Corneal NR |
Corneal LF: change from BL -0.74* Note: BL is pre-LF but post-LASIK/PRK |
LF Tx may have utility in managing dry eye symptoms following laser vision correction. Safety NR |
|
Petzold 2016 [73] Case report Germany |
N = 1 patient (2 eyes) 4 years post-LASIK with severe dry eye | 18 months | Single 12-min LF Tx |
MGYLS LF OD: 8 LF OS: 10 |
MGYLS LF OD: 12 LF OS: 13 |
SPEED LF: 20 |
SPEED LF: 12 |
TBUT LF OD: < 5 LF OS: < 5 |
TBUT LF OD: 8 LF OS: 14 |
Corneal LF OD: 2–3 LF OS: 1 |
Corneal LF OD: 0 LF OS: 0 |
LF Tx successfully treated a case of post-LASIK dry eye that was refractory to conventional treatment. Safety NR |
Units of measure are as follows: MGYLS = number of functional glands; OSDI = points, score 0–100; SPEED = points, score 0–28; staining = scale score; TBUT = seconds
AEs adverse events, BL baseline, CL control, DED dry eye disease, FU follow-up, LASIK laser-assisted in situ keratomileusis, LF LipiFlow, MG meibomian glands, MGD meibomian gland dysfunction, MGYLS meibomian glands yielding liquid secretion (glands with secretion capacity), min minutes, NR not reported, OD right eye, OS left eye, OSDI ocular surface disease index, post post-treatment, postop postoperation, pre pretreatment, preop preoperation, PRK photorefractive keratectomy, SD standard deviation, SPEED standard patient evaluation of eye dryness, TBUT tear break-up time, Tx treatment
1Data only presented in a figure. We did not extrapolate the data from the figure to avoid presenting estimated data
*P < 0.05 vs. baseline
†P < 0.05 vs. LipiFlow post-LASIK group, pre-LipiFlow