Abstract Listings 2025

Purpose

Epiphora is a common presentation of patients presenting to ophthalmology clinics and
has a significant effect on patients’ quality of life. There are a wide range of different aetiologies,
with the most common cause being nasolacrimal duct obstruction. Increasingly lid laxity and
lid malformations are becoming more prevalent, especially in the older population.
In the presence of eyelid laxity and patent nasolacrimal system on syringing, eyelid tightening
is usually the first step in management of epiphora.
There are a lack of recent studies reporting the success rates, patient satisfaction and
complications of lid tightening which is the reason for this audit.

Methods

We compiled a database of 155 patients with 219 symptomatic eyes based on those who
underwent lid tightening surgery between January 2016 and December 2024 from both
online and theatre logbooks. We recorded outcomes based on clinical notes.
Outcomes were categorised as: resolved, improved, no improvement and worsened.

Results

Epiphora resolved in 20.5% of cases (n=45) and improved in a further 56.6% of patients
(n=124). There was no improvement in epiphora in 21% of patients (n=46) and a worsening
of symptoms in 1.8% of cases (n=4). There was an overall improvement in 77.1% of cases.
A total of 42 patients required further treatment for symptomatic relief of their watery eye
symptoms. The most common complication post-op was residual swelling seen in 7 patients,
which resolved spontaneously. 5 patients suffered from minor infections and 3 patients had dry eye.

Conclusion

Our audit has demonstrated that the success rate of lid tightening surgery is around 77.1%,
which is in line with other studies. In many cases, symptoms of watery eye improve but
do not resolve completely, so patients may need to adapt to living with the effects on their daily life.
More widespread usage of scoring systems like the Munk score and patient reported questionnaires
may be helpful for looking at the effect on quality of life.
In conclusion, lid tightening for epiphora is a minimally invasive surgery which is safe, effective
and has minimal complications.

Additional Authors

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