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Miguel Angel Pérez-Silguero,1 David Pérez-Silguero,2 Amado Rivero-Santana,3 Maria Inmaculada Bernal-Blasco,4 Pablo Encinas-Pisa1 1Department of Ophthalmology, La Paloma Hospital, Las Palmas de Gran Canaria, Canary Islands, Spain; 2Department of Ophthalmology, Pérez-Silguero Ophthalmologic Clinic, Las Palmas de Gran Canaria, Canary Islands, Spain; 3Department of Health Technology Assessment, Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria, Canary Islands, Spain; 4Department of Community and Family Medicine, Primary Care Center of Cuevas Torres, Las Palmas de Gran Canaria, Canary Islands, SpainCorrespondence: Amado Rivero-SantanaServicio de Evaluación del Servicio Canario de la Salud, Camino Candelaria, 44, El Rosario, S/C de Tenerife, 38109, SpainTel +34 922478269Email amado.riverosantana@sescs.esPurpose: To assess the effectiveness of a combination of intense pulsed light and low-level light therapy (IPL/LLLT) for the treatment of dry eye.Study Design: Retrospective before-after single-center clinical study.Materials and Methods: Patients diagnosed with dry eye, refractory to conventional treatment, underwent four sessions of combined IPL/LLLT over 3 months. The Ocular Surface Disease Index (OSDI) questionnaire, non-invasive breakup time (NIBUT), tear film osmolarity and meniscus height were measured 6 months before intervention, at baseline, post-intervention (3 months), 9 and 15 months.Results: NIBUT, osmolarity and meniscus height significantly worsened during the 6 months before treatment, whereas symptoms did not change. OSDI scores significantly improved at post-intervention (MD = − 44.0, 95% CI − 38.1, − 50.0), and then increased again until the at last follow-up, but still significantly different from baseline (MD = − 30.0, 95% CI − 23.4, − 36.8). The three clinical signs showed a similar pattern, with one-year improvements of 3.6 seconds for the NIBUT (95% CI 3.1, 4.2, p < 0.001), 28 mOsm/L for osmolarity (95% CI 23.6, 32.4, p < 0.001) and 0.03 mm for meniscus height (95% CI 0.02, 0.04, p < 0.001). No adverse effects were observed.Conclusion: IPL/LLLT is safe and produces an important reduction in symptoms and signs of dry eye disease, still relevant one year after the end of treatment in a sample with high symptoms’ severity. Therefore, it represents a promising treatment option for patients who do not improve with conventional treatment. Randomized trials are needed to determine the added benefit provided by LLLT.Keywords: dry eye, meibomian gland dysfunction, intense pulsed light, low-level light therapy, retrospective study