Evaluation Of Ocular Surface And Corneal Topography After External Dacryocystorhinostomy

In primary acquired nasolacrimal duct obstruction (PANDO), impaired tear drainage may create an inflammatory environment, leading to deterioration in tear quality.The aim of our study is to determine the changes that may occur in tear break-up time (TBUT), corneal topography, and Ocular Surface Disease Index (OSDI) score after external dacryocystorhinostomy (EX-DCR). We believe that the results will contribute to preoperative patient evaluation and information, as well as postoperative patient management.

Kütahya City Hospital

Our study included patients who presented to our clinic with epiphora, were diagnosed with PANDO, and underwent EX-DCR between January 2025 and July 2025.Preoperative and postoperative TBUT and OSDI scores, as well as corneal topography parameters, were examined. Corneal topography parameters were defined as central corneal thickness (CCT), K1, K2, Km, Kmax front, corneal astigmatism, axis, and index of vertical asymmetry (IVA). All parameters were statistically compared.The distribution of variables is measured by Kolmogorov Smirnov and Shapiro-Wilk tests. Paired samples t test and Wilcoxon test were used for the repeated measurement analysis. SPSS 27.0 was used for statistical analyses.

Significant increases were observed in the mean TBUT values at 1, 3, and 6 months compared to baseline (p<0.05).There was no significant difference between the 1st, 3rd, and 6th months (p>0.05).

A significant decrease in OSDI scores was observed at 1, 3, and 6 months compared to baseline (p<0.05). A significant decrease in OSDI score was observed at 3 months compared to 1st month (p<0.05). No significant change was observed between 6 months and 3 months (p>0.05).

The mean CCT values at 1st, 3rd, and 6th months showed a significant decrease compared to baseline (p<0.05).There was no significant difference between the 1st, 3rd, and 6th months (p>0.05).

No significant changes were observed in other topographic parameters (p>0.05).

The significant increase in mean TBUT values compared to baseline and the decrease in OSDI scores indicate that EX-DCR positively affects ocular surface stability and provides symptomatic relief. The lower OSDI score in the third month compared to the first month indicates that symptomatic improvement continues alongside tissue healing.

The decrease in CCT compared to baseline, with other topographic parameters remaining stable, suggests that this decrease is related to the ocular surface. One possible reason for this change is the regulation of corneal hydration after EX-DCR.

We believe that our study is particularly valuable as it is the first study in the literature to address the relationship between EX-DCR and corneal topography.