The effects of lower lid laxity on the response to dry eye treatment

Abstract

Purpose To compare the responses to dry eye treatment of patients sorted by the degree of lower lid laxity. Methods Sixty patients were grouped into three groups according to the degree of lower lid laxity. Tear break‐up times (TBUT), Schirmer test (ST) scores, ocular surface disease index (OSDI) scores, and changes in OSDI score in each group were compared, before and at 3 months after treatment. Results TBUT, ST, and OSDI scores were not different among the three groups at baseline. TBUT improved in each group at 3 months after treatment, and no differences between groups were found. ST scores were not increased after treatment, while OSDI were improved to 22.57±5.243, 31.16±11.353, and 37.85±13.342 in the no, moderate, and high laxity groups, respectively; these improvements were statistically significant (p=0.003, <0.001, <0.001, respectively). Patients with greater than moderate lower lid laxity saw the smallest improvement in response to dry eye treatment, as assessed by change in OSDI score (p=0.005 vs. moderate laxity group, p=0.005 vs. no laxity group). Conclusion Lower lid laxity is one of the factors contributing to the manifestation of dry eye symptoms, independently of TBUT and ST scores.