Prevalence and Risk Factors of Dry Eye Symptoms after Successful Dacryocystorhinostomy for Patients with Lacrimal Passage Obstruction

Purpose To investigate the prevalence of dry eye symptoms after successful dacryocystorhinostomy and explore the potential risk factors. Methods: This cross-sectional study included 565 patients with lacrimal passage obstruction (LPO) who underwent external dacryocystorhinostomy. Ocular Surface Disease Index (OSDI) total score of 13 or more was regarded as presence of dry eye symptoms. OSDI total score greater than 22 combined with self-reported dry eye was defined as symptomatic dry eye. Logistic regression and linear regression were used to examine the associations between OSDI scores and its potentially predictive factors. Results: Of the 565 patients, 344 completed the questionnaire, among which 101(29.4%) patients presented with dry eye symptoms, including 53(15.4%) mild, 14(4.1%) moderate and 34(9.9%) severe, and 48(14.0%) patients can be defined as symptomatic dry eye. Univariate logistic regression revealed that age, educational levels, income levels, and hypertension were significantly correlated with the presence of dry eye symptoms ( P < 0.05). After multivariate adjustment, lower income levels were found significantly associated with dry eye symptoms ( P < 0.05). Univariate linear regression demonstrated that age, lower educational levels, surgery history, and hypertension were significantly associated with OSDI total score ( P = 0.037, 0.012, 0.022, 0.029 respectively). Multivariate stepwise linear regression manifested that educational levels and the surgery history influenced the OSDI total score mostly ( P = 0.021, 0.036 respectively). Conclusions: Dry eye problem of LPO patients after successful dacryocystorhinostomy cannot be ignored. In the preoperative evaluation, we should pay special attention to the elderly patients with lower educational levels, lower income levels or systemic diseases.