Abstract：Objective: To evaluate the efficacy of inferior lacrimal punctum cauterization in the treatment of two types
of severe aqueous deficient dry eyes. Methods: This was a prospective non-randomized controlled study.
Twenty-nine severe aqueous tear-deficient dry eye patients (58 eyes) treated with artificial tears and topical
anti-inflammatory conservation therapy from June 2019 to October 2020 at Department of Ophthalmology
of the Secondary Affiliated Hospital of Fujian Medical University were enrolled. Patients were divided
into two groups based on whether or not they had Sjögren's syndrome: Sjögren's syndrome dry eye
(SS) group 17 cases (34 eyes) and non-Sjögren's syndrome dry eye (non-SS) group 12 cases (24 eyes) Cauterization of the inferior lacrimal punctum was performed on all participants. Data were collected
at 2 months and 1 day before the operation, and 2 weeks and 2 months after the operation and included
ocular surface disease index (OSDI), fluorescein breakup time (TBUT), corneal fluorescein staining (FL)
and SchirmerⅠ test (SⅠT). Data was analyzed by an independent samples t test, paired samples t test and
repeated measures one-way ANOVA. Results: There was no significant difference in any clinical indicators
at baseline between the two groups. At 2 weeks and 2 months after the operation, OSDI score, TBUT
and FL were significantly improved compared to 1 day before the operation in the SS group (F=69.58, P<0.001; F=49.45, P<0.001; F=34.07, P<0.001), and OSDI score, TBUT, FL and SⅠT were significantly
improved compared to 1 day before operation in non-SS group (F=57.89, P<0.001: F=72.83, P<0.001; F=47.44, P<0.001; F=28.35; P<0.001). However, SⅠT was not significantly improved compared to 1 day
before operation in the SS group. Two months after cauterization, all four indicators in the non-SS group
improved more than those in the SS group (t=2.22, P=0.04: t=-3.32, P<0.001: t=2.90, P=0.01; t=-4.00, P<0.001). No adverse ocular effect was found in the study in two groups. The most common complication
was the recanalization of the lacrimal passage. The recanalization rate was 5.2%. Conclusions: Lacrimal
punctum cauterization is effective, simple, safe and cost-effective to relieve the symptoms and signs of
two types of severe aqueous tear-deficient dry eyes. There are more benefits for non-Sjögren's syndrome
dry eyes.
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