Purpose: To determine the effect of unilateral primary acquired nasolacrimal obstruction (PANDO) on ocular surface parameters in PANDOeyes and fellow eyes and changes in these parameters after dacryocystorhinostomy.
Methods: Tear osmolarity, tear break-up time (TBUT), Schirmer's test, Meibomian gland score, and Lissamine Green staining of PANDO eyes and fellow eyes were measured preoperatively and postoperatively at Day 15, 1 month, and 3 months. Lacrimal irrigation and epiphora symptomatology were evaluated at all follow-up visits, and patients who did not meet surgical success criteria were excluded from the study.
Results: Twenty-nine patients who underwent successful dacryocystorhinostomy surgery were included in the study. Preoperative and postoperative Day 15 Schirmer (p = .019, p = .001) and TBUT (p = .039, p = .043) were significantly lower in the fellow eye compared to PANDO eyes. The differences observed between PANDO eyes and fellow eyes in all other parameters were not significant (p > .05). Preoperatively PANDO eye parameters were normal, whereas TBUT (7.59 ± 5.39 s) and tear osmolarity (308.59 ± 17.32 mOsm/L) values of the fellow eye may be indicative of tear film instability. TBUT and tear osmolarity of the fellow eye showed significant improvement 3 months postoperatively compared to preoperative values (p = .010; p = .027 respectively).
Conclusion: Schirmer and TBUT values of the fellow eye were significantly lower than PANDO eyes preoperatively, one month after surgery there was no significant difference. TBUT and tear osmolarity of the fellow eyes may be indicative of tear instability preoperatively with improvement 3 months after dacryocystorhinostomy.
Keywords: Dacryocystorhinostomy; lacrimal functional unit; nasolacrimal duct obstruction; ocular surface; tear film instability.