Lacrimal intubation improves optical quality in patients with epiphora

The first prospective study to evaluate the visual function and optical quality in patients with epiphora before and after lacrimal surgery.

Study design

This prospective study investigated functional visual acuity, higher order aberrations, lower tear meniscus and tear clearance in 30 patients (34 eyes) who underwent lacrimal passage intubation by a single surgeon. All patients had a canalicular obstruction, nasolacrimal duct obstruction or partial nasolacrimal duct obstruction.

Outcomes

Investigators observed significant improvements in visual function as shown by improved functional visual acuity and visual maintenance ratio. There was a significant decrease in tear meniscus dimension, which correlated with decreased blinking frequency.

Optical quality significantly improved as indicated by a decrease in coma-like aberrations, spherical-like aberrations and total higher order aberrations. Stability index increased and fluctuation index decreased.

Limitations

Lacrimal intubation was aided with a dacryoendoscope, which is not readily available at other institutions. Other methods of lacrimal intubation may have a similar effect. Subjective symptoms were not evaluated.

Clinical significance

We normally counsel patients that tearing can be improved after lacrimal intubation. This study lends additional evidence that the quality of vision may also improve via enhancement of functional visual acuity, decreased blinking frequency and reduced optical aberrations.