To compare the response of dry eye treatment in patients divided by the degree of lower lid laxity.

Thirty patients were classified into three groups - normal, moderate and severe, according to the degree of lower lid laxity. Tear break-up time (TBUT), Schirmer test (ST), ocular surface disease index (OSDI) scores and changes in OSDI score in each group were compared before and at 3 months after the treatment.

TBUT, ST and OSDI scores were not different among the three groups at baseline. TBUT improved to 6.60 ± 1.43, 6.0 ± 2.54 and 6.0 ± 1.45 sec in normal, moderate and severe lower lid laxity group, respectively at 3 months after the treatment and no difference among the groups was found. ST scores did not increase after the treatment, while OSDI scores improved to 12.20 ± 1.40, 16.10 ± 4.63 and 20.80 ± 4.52 in each group, respectively and they were significantly different ( p = 0.029, 0.029, <0.001, respectively). The response to the dry eye treatment as assessed by changes in OSDI scores was poorer in patients in the severe lower lid laxity group ( p = 0.019 vs. moderate laxity group, <0.01 vs. normal group).

As the degree of lower lid laxity increases, the response to dry eye treatment becomes poorer even when TBUT increases.