Impact of habitual swimming on the success of lacrimal surgery.

PURPOSE: To elucidate how factors associated with swimming affect the lacrimal ducts of swimmers.

STUDY

DESIGN

Prospective, interventional cohort study,

METHODS

Five hundred seventy four consecutive epiphora patients were surveyed via a questionnaire regarding details of their swimming-pool usage; i.e., frequency, swim-goggles' wear, and type of pool activity (i.e., swimming vs. waist-depth walking). In this cohort, all the swimmers over 20 years old with anatomical lacrimal duct obstruction underwent surgical reconstruction. The surgical success rates at 12-months postoperative were compared using multivariable logistic regression analyses between swimmer/non-swimmer patients, those with a history of high/low frequency of pool usage, and those with high/low amount of conjunctival contact with the swimming-pool water.

RESULTS

Of the patients with anatomical lacrimal duct obstruction, 6.4% were habitual swimmers; nasolacrimal duct obstruction was more common in the swimmers than in the non-swimmers' controls (89.1%/66.7%, P = 0.025). The success rate of lacrimal surgery for the swimmers with anatomical nasolacrimal duct obstruction was lower (60.6%) than of the non-swimmers (83.3%, P = 0.048). A receiver operating characteristic curve analysis of the frequency for the prediction of surgical failure showed that the threshold was 4 days/week. The success rate was statistically lower (26.7%) in the high-frequency swimmers compared to the low-frequency swimmers (88.9%, P = 0.037). However, no statistical difference in the high/low ocular surface contact to the swimming-pool water was observed (71.4%/57.7%, P = 0.56).

CONCLUSION

Habitual swimmers have a high risk of nasolacrimal-duct damage retrogradely from the nasal cavity that lowers lacrimal surgery's success rate.