Dry Eye Disease Management Via Technological Methods: A Systematic Review and Network Meta-analysis
Abstract Introduction In recent years, various technological therapeutic modalities have emerged aiming to target the underlying pathophysiology of dry eye disease (DED). Methods A systematic search was conducted in PubMed, Scopus, and Embase databases up to July 29, 2023, using predefined search te...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Adis, Springer Healthcare
2025-07-01
|
| Series: | Ophthalmology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40123-025-01187-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849332958770495488 |
|---|---|
| author | Dror Ben Ephraim Noyman Clara C. Chan Joshua C. Teichman Itamar Arbel Or Yosefi Ruth Lapid-Gortzak Michael Mimouni Margarita Safir |
| author_facet | Dror Ben Ephraim Noyman Clara C. Chan Joshua C. Teichman Itamar Arbel Or Yosefi Ruth Lapid-Gortzak Michael Mimouni Margarita Safir |
| author_sort | Dror Ben Ephraim Noyman |
| collection | DOAJ |
| description | Abstract Introduction In recent years, various technological therapeutic modalities have emerged aiming to target the underlying pathophysiology of dry eye disease (DED). Methods A systematic search was conducted in PubMed, Scopus, and Embase databases up to July 29, 2023, using predefined search terms related to DED and technological treatments, including intense pulsed light (IPL), LipiFlow, TearCare, iLux, low-level light therapy (LLLT), and acupuncture. Randomized controlled trials (RCTs) evaluating technological interventions for DED with outcome measures for tear secretion, meibomian gland quality, tear break-up time (TBUT), corneal surface health, and symptom scores at 1–2 months post-treatment were included. Data extraction followed PRISMA guidelines. Risk of bias was assessed using Cochrane guidelines. A random-effects frequentist network meta-analysis model was employed, and standardized mean differences (SMDs) were calculated for comparative analyses. P-scores were used to rank treatment efficacy. Results Ultimately, 45 RCTs involving 3455 patients were included. TearCare combined with meibomian gland expression (MGX) demonstrated the highest efficacy for improving meibomian gland secretion (SMD − 10.08, 95% CI − 13.35 to − 6.82). IPL-based treatments, including IPL combined with diquafosol sodium or LLLT, significantly improved TBUT and symptom scores, with IPL alone ranking highest for symptom relief (P-score 0.811). Acupuncture was the only intervention significantly superior to conservative treatment for increasing Schirmer test values (SMD − 0.69, 95% CI − 1.06 to − 0.32). LipiFlow demonstrated modest improvements but was not significantly superior to other technologies. Conclusions These findings underscore the potential of advanced technological interventions in the short-term management of DED and support the need for standardized, long-term comparative studies. |
| format | Article |
| id | doaj-art-0aa88a672859477d9867ab30032ef3d1 |
| institution | Kabale University |
| issn | 2193-8245 2193-6528 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Ophthalmology and Therapy |
| spelling | doaj-art-0aa88a672859477d9867ab30032ef3d12025-08-20T03:46:03ZengAdis, Springer HealthcareOphthalmology and Therapy2193-82452193-65282025-07-011481917195410.1007/s40123-025-01187-yDry Eye Disease Management Via Technological Methods: A Systematic Review and Network Meta-analysisDror Ben Ephraim Noyman0Clara C. Chan1Joshua C. Teichman2Itamar Arbel3Or Yosefi4Ruth Lapid-Gortzak5Michael Mimouni6Margarita Safir7Ophthalmology Department, Rambam Health Care Campus, Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of TechnologyDepartment of Ophthalmology and Vision Sciences, University of TorontoDepartment of Ophthalmology and Vision Sciences, University of TorontoOphthalmology Department, Meir Medical Center, Faculty of Medicine, Tel Aviv UniversityOphthalmology Department, Barzilay Medical Center, Faculty of Medicine, Ben-Gurion University of the NegevDepartment of Ophthalmology, Amsterdam University Medical CentresOphthalmology Department, Rambam Health Care Campus, Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of TechnologyOphthalmology Department, Rabin Medical Center, Faculty of Medicine, Tel Aviv UniversityAbstract Introduction In recent years, various technological therapeutic modalities have emerged aiming to target the underlying pathophysiology of dry eye disease (DED). Methods A systematic search was conducted in PubMed, Scopus, and Embase databases up to July 29, 2023, using predefined search terms related to DED and technological treatments, including intense pulsed light (IPL), LipiFlow, TearCare, iLux, low-level light therapy (LLLT), and acupuncture. Randomized controlled trials (RCTs) evaluating technological interventions for DED with outcome measures for tear secretion, meibomian gland quality, tear break-up time (TBUT), corneal surface health, and symptom scores at 1–2 months post-treatment were included. Data extraction followed PRISMA guidelines. Risk of bias was assessed using Cochrane guidelines. A random-effects frequentist network meta-analysis model was employed, and standardized mean differences (SMDs) were calculated for comparative analyses. P-scores were used to rank treatment efficacy. Results Ultimately, 45 RCTs involving 3455 patients were included. TearCare combined with meibomian gland expression (MGX) demonstrated the highest efficacy for improving meibomian gland secretion (SMD − 10.08, 95% CI − 13.35 to − 6.82). IPL-based treatments, including IPL combined with diquafosol sodium or LLLT, significantly improved TBUT and symptom scores, with IPL alone ranking highest for symptom relief (P-score 0.811). Acupuncture was the only intervention significantly superior to conservative treatment for increasing Schirmer test values (SMD − 0.69, 95% CI − 1.06 to − 0.32). LipiFlow demonstrated modest improvements but was not significantly superior to other technologies. Conclusions These findings underscore the potential of advanced technological interventions in the short-term management of DED and support the need for standardized, long-term comparative studies.https://doi.org/10.1007/s40123-025-01187-yDry eye diseaseMeibomian gland dysfunctionIntense pulsed light |
| spellingShingle | Dror Ben Ephraim Noyman Clara C. Chan Joshua C. Teichman Itamar Arbel Or Yosefi Ruth Lapid-Gortzak Michael Mimouni Margarita Safir Dry Eye Disease Management Via Technological Methods: A Systematic Review and Network Meta-analysis Ophthalmology and Therapy Dry eye disease Meibomian gland dysfunction Intense pulsed light |
| title | Dry Eye Disease Management Via Technological Methods: A Systematic Review and Network Meta-analysis |
| title_full | Dry Eye Disease Management Via Technological Methods: A Systematic Review and Network Meta-analysis |
| title_fullStr | Dry Eye Disease Management Via Technological Methods: A Systematic Review and Network Meta-analysis |
| title_full_unstemmed | Dry Eye Disease Management Via Technological Methods: A Systematic Review and Network Meta-analysis |
| title_short | Dry Eye Disease Management Via Technological Methods: A Systematic Review and Network Meta-analysis |
| title_sort | dry eye disease management via technological methods a systematic review and network meta analysis |
| topic | Dry eye disease Meibomian gland dysfunction Intense pulsed light |
| url | https://doi.org/10.1007/s40123-025-01187-y |
| work_keys_str_mv | AT drorbenephraimnoyman dryeyediseasemanagementviatechnologicalmethodsasystematicreviewandnetworkmetaanalysis AT claracchan dryeyediseasemanagementviatechnologicalmethodsasystematicreviewandnetworkmetaanalysis AT joshuacteichman dryeyediseasemanagementviatechnologicalmethodsasystematicreviewandnetworkmetaanalysis AT itamararbel dryeyediseasemanagementviatechnologicalmethodsasystematicreviewandnetworkmetaanalysis AT oryosefi dryeyediseasemanagementviatechnologicalmethodsasystematicreviewandnetworkmetaanalysis AT ruthlapidgortzak dryeyediseasemanagementviatechnologicalmethodsasystematicreviewandnetworkmetaanalysis AT michaelmimouni dryeyediseasemanagementviatechnologicalmethodsasystematicreviewandnetworkmetaanalysis AT margaritasafir dryeyediseasemanagementviatechnologicalmethodsasystematicreviewandnetworkmetaanalysis |