Etiopathogenesis of primary acquired nasolacrimal duct obstruction (PANDO)

Ali, Mohammad Javed

doi:10.1016/j.preteyeres.2023.101193

Cited by 15 publications

(3 citation statements)

References 196 publications

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“… 2 Several factors have been proposed to contribute to the development of nasolacrimal duct obstruction (NLDO), such as anatomical variation, vascular changes, autonomic dysfunction, sino-nasal factors, hormonal influences, tear-related factors, and the lacriome. 3 …”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and cytological changes in mucinous obstruction diagnosed by dacryoendoscopy

Kim,

Lew

2024

Sci Rep

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To analyze the clinical characteristics of mucinous obstruction diagnosed by dacryoendoscopy and compared the cytological changes with membranous obstruction using a modified liquid-based thin prep cytology method. A retrospective chart review was conducted on 53 eyes of 51 patients with mucus obstruction based on dacryoendoscopic findings from January 2022 to October 2022. Liquid-based thin-prep cytology was performed by irrigating the inside of the nasolacrimal drainage system with saline during dacryoendoscopy-guided silicone tube intubation. Pathological findings were analyzed through a comparison of mucinous obstruction with membranous obstruction as determined by dacryoendoscopic findings. The modified liquid-based thin prep cytology technique had a higher cytology detection rate across all cases. Mucinous obstruction exhibited a significantly higher number of successful canalicular irrigation test cases compared to membranous obstruction. In mucinous obstruction, epithelial squamous cells were more frequently detected in pre-sac obstruction, whereas columnar epithelial cells were predominant in post-sac obstruction. Inflammatory cells showed a stronger correlation with primary change and post-sac obstruction. Bacterial colonies were observed exclusively in cases of mucinous obstruction. The use of a modified liquid-based thin prep cytology method enables the examination of histopathological changes in the lacrimal passage in primary acquired nasolacrimal duct obstruction (PANDO), particularly in cases of mucinous obstruction, without the need for invasive biopsies. These findings enhance the understanding of the etiopathogenesis of mucinous obstruction, complementing knowledge of membranous obstruction in PANDO.

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Section: Introductionmentioning

confidence: 99%

Clinical characteristics and cytological changes in mucinous obstruction diagnosed by dacryoendoscopy

Kim,

Lew

2024

Sci Rep

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“…In cases in which no specific etiopathological factors are advised, this condition is known as primary nasolacrimal duct obstruction (PANDO), which accounts for most cases [2]. According to recent evidence, PANDO is considered a multi-factorial disease, driven by both genetic and acquired predisposing conditions, such as vascular factors, local hormonal imbalance, microbial influence, nasal abnormalities, and autonomic dysregulation, which eventually turns into lacrimal drainage system narrowing and obstruction [3]. Dacryocystorhinostomy (DCR) is the mainstay of treatment for PANDO, allowing the surgeon to overcome tear drainage blockage by opening the lacrimal sac onto the lateral nasal wall through an external or endonasal approach.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Endoscopic Endonasal Dacryocystorhinostomy in Glaucoma Patients

Pace,

Giombi,

Muci

et al. 2024

JPM

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Background: Anti-glaucoma eye drops have been investigated due to their production of fibrotic changes on the conjunctival surface, undermining the functioning of the upper lacrimal drainage system. We aimed to assess whether these effects may impair the effectiveness of endoscopic endonasal dacryocystorhinostomy (EE-DCR). Methods: This is a single-center observational retrospective study on EE-DCR via a posterior approach. Resolution of epiphora and dacryocystitis were analyzed after 1 (T1) and 6-months (T2) from surgery. Surgical success was defined as anatomical (patency at irrigation, no recurring dacryocystitis) or complete (zeroing of Munk score). Results: Twenty patients (32 sides) were enrolled. Preoperatively, 93.75% (n = 30/32) presented severe (Munk 3–4) epiphora and 68.75% (n = 22/32) recurrent dacryocystitis. At T1, 50.0% (n = 16/32) were referred with residual epiphora (Munk ≥ 1) and 18.75% (n = 6/32) dacryocystitis. At T2, 31.25% (n = 10/32) still complained of epiphora (Munk ≥ 1) and 6.25% (n = 2/32) dacryocystitis. Difference of outcomes at aggregate and paired timepoints (except for T1 versus T2) resulted in statistical significance (p < 0.05). At T2, 22 (68.75%) complete, 8 (25.0%) anatomical successes and 2 (6.25%) surgical failures were observed. Conclusions: Despite the chronic uptake of anti-glaucoma eye drops, EE-DCR guaranteed high rates of clinical relief from epiphora and remarkable decreases in the rates of recurrent dacryocystitis.

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“…1 The etiopathogenesis of lacrimal duct obstruction appears to be multifactorial. 2 Dacryocystorhinostomy (DCR) is the preferred surgery for nasolacrimal duct obstruction (NLDO) but may be complicated by nasal bleeding, skin scar and granuloma. 3 With the development of dacryoendoscope, silicone intubation has emerged as a common option to address NLDO.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes and prognostic factors in patients with nasolacrimal duct obstruction or stenosis using dacryoendoscopy

Li,

Zhang

et al. 2024

Preprint

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Silicone intubation has emerged as a common option to address nasolacrimal duct obstruction (NLDO) or stenosis. Although dacryoendoscope has increased the success rate of silicone intubation, the success rates were significantly different. Furthermore, no study has comprehensively assessed the risk factors of treatment failure after silicone intubation. In this study, we aim to evaluate the effectiveness of dacryoendoscopic-assisted laser dacryoplasty with silicone intubation (DLDI) for the management of NLDO or stenosis, and to identify the factors associated with treatment failure. A total of 522 patientswith NLDO or stenosis who underwent DLDI from December 2019 to December 2021 at Tianjin Eye Hospital were considered for enrollment. The overall anatomic success rate was 84.8% for the entire cohort at the 2-year follow-up. In the multivariable model, a higher risk of failed DLDI surgery was associated with a history of chronic dacryocystitis (HR=3.07; P < 0.001) and a longer duration of epiphora than 1 year (HR=2.67; P < 0.001). Of the 522 patients, 37 patients (7.1%) had surgery-related complications. DLDI is an effective minimally invasive technique for treatment in patients with distal NLDO or stenosis. Factors associated with higher risk of reoperation include a longer duration of epiphora and a history of chronic dacryocystitis.

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Etiopathogenesis of primary acquired nasolacrimal duct obstruction (PANDO)

Cited by 15 publications

References 196 publications

Clinical characteristics and cytological changes in mucinous obstruction diagnosed by dacryoendoscopy

Clinical characteristics and cytological changes in mucinous obstruction diagnosed by dacryoendoscopy

Outcomes of Endoscopic Endonasal Dacryocystorhinostomy in Glaucoma Patients

Clinical outcomes and prognostic factors in patients with nasolacrimal duct obstruction or stenosis using dacryoendoscopy

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