Impact of external dacryocystorhinostomy on corneal aberrations and optical quality in primary acquired nasolacrimal duct obstruction.

IF 1.4 4区医学 Q3 OPHTHALMOLOGY

International Ophthalmology Pub Date : 2025-09-01 DOI:10.1007/s10792-025-03725-w

Titap Yazıcıoglu, Murat Oklar, Dilara Ozkoyuncu Kocabas

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引用次数: 0

Abstract

Purpose: To assess the impact of external dacryocystorhinostomy (EXT-DCR) on optical quality in patients with primary acquired nasolacrimal duct obstruction (PANDO) by evaluating changes in corneal higher-order aberrations (HOAs) and key optical quality parameters, including modulation transfer function (MTF) and point spread function (PSF).

Methods: This retrospective study included 26 eyes of 26 patients who underwent unilateral EXT-DCR for PANDO. Preoperative and 6-month postoperative assessments included best-corrected visual acuity (BCVA), manifest refraction spherical equivalent (MRSE), and epiphora severity (Munk score, fluorescein dye disappearance test [FDDT]). HOAs, MTF, and PSF were analyzed at 3 mm and 6 mm pupil diameters using Sirius corneal topography. Paired t-tests, Wilcoxon signed-rank tests, and Spearman correlation analyses were used.

Results: Postoperatively, HOA significantly decreased at 3 mm (0.183 ± 0.160 - 0.128 ± 0.058 µm, p = 0.020) and 6 mm (0.744 ± 0.350 - 0.641 ± 0.271 µm, p = 0.039). Spherical aberration at 6 mm also significantly decreased (- 0.237 ± 0.203 - - 0.194 ± 0.247 µm, p = 0.032). MTF and PSF values showed no significant postoperative changes (p > 0.05). Correlation analysis of Δ values (preoperative-postoperative changes) revealed significant associations between reductions in Munk/FDDT scores and improvements in HOA and spherical aberrations (p < 0.05).

Conclusion: EXT-DCR may significantly improve optical quality by reducing HOAs and spherical aberrations. The correlation between epiphora resolution and optical quality suggests that stabilizing the tear film plays a key role in reducing optical distortions. While MTF and PSF values did not show significant changes, further studies with larger cohorts and advanced imaging techniques are warranted to explore the broader impact of lacrimal surgery on visual function and contrast sensitivity parameters.

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外泪囊鼻腔造口术对原发性获得性鼻泪管阻塞患者角膜像差及光学质量的影响。

目的：通过评价角膜高阶像差（HOAs）及调制传递函数（MTF）、点扩散函数（PSF）等关键光学质量参数的变化，探讨泪囊鼻腔外造口术（EXT-DCR）对原发性获得性鼻泪管梗阻（PANDO）患者光学质量的影响。方法：回顾性研究26例单侧行EXT-DCR治疗PANDO患者26只眼。术前和术后6个月的评估包括最佳矫正视力（BCVA）、明显折射球当量（MRSE）和显色严重程度（Munk评分、荧光素染料消失试验[FDDT]）。利用Sirius角膜地形图分析3 mm和6 mm瞳孔直径下的HOAs、MTF和PSF。采用配对t检验、Wilcoxon符号秩检验和Spearman相关分析。结果：术后HOA在3 mm（0.183±0.160 ~ 0.128±0.058µm, p = 0.020）和6 mm（0.744±0.350 ~ 0.641±0.271µm, p = 0.039）处明显降低。6 mm处球差也显著降低（- 0.237±0.203 ~ - 0.194±0.247µm, p = 0.032）。MTF和PSF值术后无明显变化（p < 0.05）。Δ值（术前-术后变化）的相关分析显示，Munk/FDDT评分的降低与HOA和球差的改善之间存在显著相关性(p结论：EXT-DCR可能通过降低HOA和球差显著改善光学质量。表观分辨率与光学质量之间的相关性表明，稳定泪膜在减少光学畸变方面起着关键作用。虽然MTF和PSF值没有显示出明显的变化，但进一步的研究需要更大的队列和先进的成像技术来探索泪道手术对视觉功能和对比敏感度参数的更广泛影响。

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来源期刊

International Ophthalmology OPHTHALMOLOGY-

CiteScore

3.20

自引率

0.00%

发文量

451

期刊介绍： International Ophthalmology provides the clinician with articles on all the relevant subspecialties of ophthalmology, with a broad international scope. The emphasis is on presentation of the latest clinical research in the field. In addition, the journal includes regular sections devoted to new developments in technologies, products, and techniques.