Early recognition, management of LDS stenosis lowers burden in patients undergoing surgery
Reflex tearing by Meibomian gland dysfunction must be considered for proper tearing management due to the high incidence of accompanying Meibomian gland loss in cases of lacrimal drainage system (LDS) obstruction, suggests a recent study.
“Early recognition and management of LDS stenosis could result in patients undergoing surgery with a lower burden,” the authors said.
Thirty-four eyes of 17 patients (mean age 62.4 years) were included in the analysis, with a mean follow-up period of 9.6 months. Ten eyes (29.4 percent) displayed total regurgitation on syringing, while 19 eyes (55.9 percent) showed partial regurgitation and five eyes (14.7 percent) showed no regurgitation. Mean lipid layer thickness on LipiView was 34.5 nm (range, 20–89 nm). Mean meibo scores were 2.15 and 2.53 in the upper and lower eyelids, respectively.
Patients were given the following treatment: silicon tube intubation (STI; 10 eyes) dacryocystorhinostomy (DCR; dour eyes), conjuctivodacryocystorhinostomy (CDCR; eight eyes), DCR combined with CDCR (one eye) and conservative care (11 eyes). Mean time interval from onset of tearing to first clinic visit was 1.4 months in the conservative care group, 2.9 months in the STI and DCR groups, and 6.0 months in the CDCR group.
In this study, the authors retrospectively reviewed the clinical records of patients who complained of tearing between August 2014 and February 2016 and underwent or were undergoing chemotherapy. The following clinical measurements were used: LipiView interferometer (lipid layer thickness and meibography), lacrimal drainage examinations (syringing) and outcomes at 6 months after treatment.