The Effect of Vidian Neurectomy on the Ocular Surface - The Primary Results from a Six-Month Pilot Study.

Purpose: To evaluate the effect of vidian neurectomy (VN) on the ocular surface and the possibility of dry eye in the treatment of allergic rhinitis.

Methods: Twelve participants were recruited in this prospective study. Prior to and after 1 and 6 months of VN, an ocular surface disease index (OSDI) questionnaire was obtained, and the Schirmer's tear test (STT), break-up time (BUT), corneal fluorescence staining (CFS) score, and Keratograph 5M were used to evaluate the ocular surface condition.

Results: Two patients (16.67%) met the dry eye diagnosis criteria one month after surgery; however, their symptoms were relieved after to 3-4 months and none of them met the diagnostic criteria for dry eye after six months. Compared with the baseline values, the STT was significantly reduced (=0.002), while the tear meniscus height (TMH) (=0.262), break-up time (BUT) (=0.916), first keratographic tear film break-up time (NK-BUT) (=0.791), and average keratographic break-up time (NK-BUT) (=0.970) did not change significantly 6 months after surgery. The degree of STT decreased from baseline to 6-month and was related to the basic STT ( 0.837, =0.001) and sex ( -0.584, = 0.026) but not to age, OSDI score, BUT, NK-BUT, NK-BUT or CFS (all >0.05). Among these factors, STT at baseline was confirmed to be a predictor of a decline in tear secretion after surgery (B = 0.731, <0.001).

Conclusion: In this 6-month prospective pilot study, decreased tearing was observed after VN, but this decrease did not increase the possibility of dry eyes.