Two hundred and eight cases of failed dacryocystorhinostomy presenting to the Lacrimal Clinic at Moorfields Eye Hospital between 1970 and 1985 were reviewed. All cases underwent a further operation. The reasons for failure were usually apparent on reoperation. The surgical technique is described. A second dacryocystorhinostomy is a highly successful technique that spares both patient and surgeon the lifelong commitment to a bypass tube. At the time of operation the appropriate procedure was performed by a technique described more completely below. Possible reasons for failure of the primary operation were noted. After discharge the day after operation patients were seen one week postoperatively, at six weeks, and again at three months. Canalicular tubing, if introduced, was removed three months later. The 152

No abstract

: Botulinum toxin type A may be used in the inflammatory stage of thyroid eye disease to improve upper eyelid retraction. Individual response to treatment is variable, but this modality should be considered as a temporizing measure until stability for surgery is reached.

No abstract