Punctal occlusion and blepharoplasty in patients with dry eye syndrome

Blepharoplasty and inferior punctal occlusion were performed on 24 consecutive patients with dry eye syndrome. Fifteen patients (62.5%) had symptomatic dry eye syndrome preoperatively and nine patients (37.5%) had asymptomatic dry eye syndrome diagnosed during the preoperative workup (subclinical dry eye syndrome). After surgery, nine patients (37.5%) had improvement of their dry eye syndrome, 10 patients (42%) were unchanged, and two patients (8%) had worsening of their dry eye syndrome. A third patient had worsening of the dry eye syndrome 6 months postoperatively when her puncta reopened. Two patients (8%) had increased irritation only when wearing contact lenses, but in one patient this resolved 6 months after surgery. Thus, although a significant number are improved, a few patients will have worsening of dry eye syndrome after blepharoplasty and inferior punctal occlusion.