Global survey of lacrimal surgeons on practice of nasolacrimal duct obstruction amid COVID-19 pandemic


  • Chun Wah Lam Hong Kong Eye Hospital
  • Tessa Fayers Imperial College Healthcare NHS Trust
  • Hunter Kwok-lai Yuen Hong Kong Eye Hospital; The Chinese University of Hong Kong
  • Reynaldo Javate University of Santo Tomas Hospital
  • Jane Olver Clinica London


COVID-19, Lacrimal duct obstruction, Surveys and questionnaires


Objective: To survey lacrimal surgeons worldwide on their practice of nasolacrimal duct obstruction amid the COVID-19 pandemic.

Methods: A 24-question survey was designed to investigate lacrimal surgeons worldwide on their practice of nasolacrimal duct obstruction before the COVID-19 outbreak, during the first wave of COVID-19 pandemic (Spring 2020), and during the study period (12 March 2021 to 12 May 2021). The survey was uploaded to a website, and the link of the survey was sent to international oculoplastic societies for further distribution to their members.

Results: A total of 570 respondents from 68 countries or regions were included in the analysis. During the study period, the preferred surgical technique for nasolacrimal duct obstruction was external dacryocystorhinostomy (DCR) [69.9%], followed by endoscopic DCR (46.0%). 95.1% of respondents performed silicone intubation. When the risk of COVID-19 infection was high, respondents preferred external DCR to endoscopic DCR. Respondents used higher levels of PPE for lacrimal irrigation and surgery during the study period than before the COVID-19 outbreak, in compliance with guidelines on aerosol-generating medical procedures.

Conclusions: Amid the COVID-19 pandemic, the preferred surgical treatment worldwide for nasolacrimal duct obstruction remains external DCR. The experience gained from the COVID-19 pandemic enables lacrimal surgeons to better prepare for future pandemics.

Author Biographies

Chun Wah Lam, Hong Kong Eye Hospital


Tessa Fayers, Imperial College Healthcare NHS Trust

Consultant ophthalmic surgeon, Department of Ophthalmology, Imperial College Healthcare NHS Trust

Hunter Kwok-lai Yuen, Hong Kong Eye Hospital; The Chinese University of Hong Kong

Deputy Hospital Chief Executive, Hong Kong Eye Hospital

Department of Ophthalmology and Visual Sciences, CUHK

Reynaldo Javate, University of Santo Tomas Hospital

University of Santo Tomas Hospital, Department of Ophthalmology, Manilla, Philippines

Jane Olver, Clinica London

Clinica London, Ophthalmology, London


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How to Cite

Lam CW, Fayers T, Yuen KL, Javate R, Olver J. Global survey of lacrimal surgeons on practice of nasolacrimal duct obstruction amid COVID-19 pandemic. Hong Kong J Ophthalmol [Internet]. 2022Dec.29 [cited 2024Jul.14];26(2). Available from:



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