Purpose: To investigate the long-term efficacy of dacryoendoscopy-guided recanalization and silicone tube intubation in patients with obstruction in the lacrimal drainage system and to identify factors related to surgical outcome. Methods:We retrospectively reviewed the medical records of patients with primary nasolacrimal duct obstruction and canalicular obstruction who underwent dacryoendoscopy-guided recanalization and silicone tube intubation between August 2014 and March 2016. Factors related to surgical outcome were examined and compared between the success group (eyes with complete response and partial response) and the failure group. Kaplan-Meier survival analysis and multivariable logistic regression analysis were used to analyze the success rate according to the factors found to have statistical significance. Results:The study included 74 eyes of 51 patients. The mean age of the patients was 60.3 ± 10.0 years (range: 34-80 years). The success group consisted of 66 eyes (89.2%) (complete response: 56 eyes (75.7%) and partial response: 10 eyes (13.5%)) and the failure group consisted of 8 eyes (10.8%). The median follow-up period was 58 months (range: 6.5-72 months), and the overall success rate was 89.2%. Compared to the eyes with preoperative lacrimal irrigation test of partial passage, the eyes with no passage were associated with a lower success rate (95.9% vs. 76.0%, P = 0.01). Postoperative inflammation was also associated with a lower success rate (96.6% vs. 60.0%, P < 0.001). Conclusion:Dacryoendoscopy-guided recanalization and silicone tube intubation is effective and can be considered a first-choice of treatment for eyes which show partial passage in the lacrimal irrigation test. The management of postoperative inflammation is essential to ensure surgical success.

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Purpose: To analyze the effects of preoperative corneal asphericity on the refractive outcomes of multifocal intraocular lens implantation by correlating Q-values on anterior corneal surfaces and the prediction errors after surgery. Methods: Fifty-six eyes of 39 patients who underwent phacoemulsification, and multifocal intraocular lens implantation were included in this retrospective study. Intraocular lens power was calculated using the SRK/T, Hoffer Q, and Haigis formulas. The Q-values were measured at 6 mm, 7 mm, 8 mm, 9 mm, and 10 mm with a rotating Sheimpflug camera (Pentacam ® , Oculus, Wetzlar, Germany). The relationship between the prediction errors and the Q-values at 6 mm, 7 mm, 8 mm, 9 mm, and 10 mm were assessed by linear regression. Results: Two different multifocal intraocular lens models (Acrysof IQ RESTOR +2.5D SV25T0 [Alcon Laboratories Inc., Fort Worth, TX, USA] and ZEISS AT LISA tri 839MP [Carl Zeiss Meditec AG, Inc., Jena, Germany]) were implanted in 56 eyes. In both groups, regression analyses showed statistically significant relationships between the prediction errors and the Q-values at 6 mm, 7 mm, and 8 mm using the SRK/T formula. The correlation coefficient between the Q-values and the prediction errors were higher using the SRK/T formula than using the Hoffer-Q and Haigis formulas. Conclusions: Corneal asphericity affected refractive power during implantation of a multifocal intraocular lens and, as the preoperative Q-value increased, it resulted in a hyperopic refractive outcome for oblate corneas. These results were especially prominent when the SRK/T formula was used.