Ocular surface parameters changes following endoscopic Dacryocystorhinostomy in Primary Acquired Nasolacrimal Duct Obstruction

Abstract

Abstract Purpose: To evaluate Ocular surface parameters in patients with epiphora caused byprimary acquired nasolacrimal obstruction(PANDO), before and after endoscopic dacryocystorhinostomy (EDCR) and to compare with fellow eyes. Materials and Methods: One hundred and twenty-nine patients who underwent successful dacryocystorhinostomy surgery were included in the study.The Sjögren’s International Collaborative Clinical Alliance (SICCA) ocular staining score (OSS), tear break-up time (TBUT), Schirmer tear test (with and without anesthesia), and Lid wiper staining score of PANDO eyes and fellow eyes were measured preoperatively and postoperatively at 1 month. Results: Preoperatively,the SICCA OSS score of the PANDO eye was significantly lower than that of the fellow eye (P<0.001),Schirmer test I (without anesthesia) of PANDO eye was significantly higher than that of fellow eye(P=0.024).The differences observed between PANDO eyes and fellow eyes in all other parameters were not significant (p>0 .05).After surgery, the differences between the PANDO eye and fellow eye gradually disappeared(p>0 .05). In PANDO eyes,when comparing preoperative values with postoperative values，SICCA OSS values showed a statistically significant increase（P<0.001），Schirmer tear test (without and with anesthesia)(P=0,P=0.046)、and Lid wiper staining Korb score(P=0.004)showed a statistically significant decrease. In fellow eyes,when comparing preoperative values with postoperative 1-monthvalues, the Korb score of the fellow eye was significantly lower after surgery than before (P=0.004),all other parameters showed no significant changes. Conclusions: Obstruction of Nasolacrimal Duct results in the decrease of tear clearance and the increase of wetness of ocular surface.After successful endoscopic dacryocystorhinostomy （EDCR）surgery,the moisturization of PANDO eyes were reduced,the differences observed between PANDO eyes and fellow eyes in all parameters were disappeared.