Current lacrimal irrigation practices in China: a multicenter cross-sectional survey

To explore the real-world status of lacrimal irrigation practices in ophthalmology departments at different-level hospitals across China, and to generate empirical evidence that may inform the future development of relevant clinical standards. A multicenter cross-sectional survey study. From February 1st to February 20th, 2024, an online questionnaire survey was conducted among ophthalmic medical staff across the country to investigate the current clinical application status of lacrimal irrigation techniques. The survey focused on the operators, the selection of materials and the implementation process of the technique, and the results were summarized and analyzed. A total of 1,309 valid questionnaires were received, covering 1,177 hospitals across all provinces, autonomous regions, and municipalities directly under the central government. Among these, 83.3% were Class-A tertiary hospitals. Most respondents reported that their hospitals had standard operating procedures (SOPs) for lacrimal irrigation (94.7%) and assessment criteria (92.7%). In 33.8% of cases, no compression of the lacrimal sac area was required prior to the procedure. Respondents reported anaesthetic administration was required in 90.8% of reported procedures, with 57.8% requiring a single dose and 25% requiring two doses. The primary irrigation solution selected was 0.9% sodium chloride solution (95.7%). Self-reported procedural adverse events included subcutaneous eyelid oedema (46.7%), damage to ocular tissues (lacrimal punctum, lacrimal duct, conjunctiva, cornea) (61.0%), and other adverse events (25.9%). Post-procedure documentation most frequently recorded the reflux condition (95.1%), followed by the needle insertion site (72.8%) and pushing resistance (63.1%). Lacrimal irrigation is an important procedure for the initial diagnosis and management of lacrimal system diseases and serves as an essential preoperative test before intraocular surgery. However, nationally unified clinical standards and practice norms for this procedure are lacking, and practice execution may be influenced by operators’ subjective experience. Findings from this survey may provide real-world clinical evidence to inform the future development of relevant standards and clinical practice recommendations for lacrimal irrigation.