Long-term Efficacy of Dacryoendoscopy-guided Recanalization and Silicone Tube Intubation

Kim, Sung Eun; Beak, Jin Uk; Paik, Ji-Sun; Park, Juwan; Yang, Suk-Woo

doi:10.3341/kjo.2021.0117

Cited by 12 publications

(12 citation statements)

References 26 publications

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“…It was commonly suggested that the factors affecting the success of silicone tube intubation were the preoperative saline irrigation test and the degree of obstruction. Factors affecting the success rate are age, the degree of obstruction and the duration of follow-up [10,11]. Recently, studies on long-term results after surgery are being conducted gradually.…”

Section: Dacryoendoscopic Findingsmentioning

confidence: 99%

Dacryoendoscopic Findings in the Failed Silicone Tube Intubations without Dacryoendoscopy

Kim

Lee

2022

Korean J Ophthalmol

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To investigate the clinical characteristics and dacryoendoscopic findings and clinical efficacy of silicone tube intubation in the patients who referred to our hospital due to failed with conventional silicone tube intubation. Methods:We retrospectively reviewed the medical records of 61 cases from 50 patients who underwent silicone tube intubation or endo-dacryocytorhinostomy using dacryoendoscopy from January 2016 to May 2021. Clinical characteristics, tear meniscus height, lacrimal irrigation test, dacryocystographic findings, dacryoendoscopic findings and surgical outcomes were evaluated. Results:The study included 12 males and 38 females (mean age 64.1 ± 13.2). In the preoperative lacrimal irrigation test, passage was found in 33 eyes (54.1%) and no passage in 28 eyes (45.9%). The causes of lacrimal duct obstruction were stenosis (31.1%), mucus (27.9%), membrane (24.6%), granulation (13.1%), stone (3.3%) in order and the location were nasolacrimal duct (39.3%), lacrimal sac (36.1%), canaliculus (21.3%), inferior meatus (3.3%) in order. As for the characteristics of obstruction, the secretory type was 21 eyes (34.4%) and structural change type was 40 eyes (65.6%). The silicone tube intubation group consisted of 57 eyes (93.4%) and endo-dacryocytorhinostomy consisted of 4 eyes (6.6%). The overall success rate was 83.9%. Clinical results were correlated with dacryoendoscopic finding (P=0.015), but not with lacrimal irrigation test or dacryocystography. The structural change type had a higher surgical success rate than the secretory type (84.4% vs. 66.7%, P=0.015). In particular, the structural change type showed higher success rate than the secretory type below the lacrimal sac (95.5% vs. 61.9%, P=0.034). Conclusion:Silicone tube intubation using dacryoendoscopy has a higher surgical success rate than conventional silicone tube intubation since dacryoendoscopy provides direct visualization of nasolacrimal duct obstruction. It could be useful in increasing the surgical success rate in patients with structural changes below lacrimal sac.

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Section: Dacryoendoscopic Findingsmentioning

confidence: 99%

Dacryoendoscopic Findings in the Failed Silicone Tube Intubations without Dacryoendoscopy

Kim

Lee

2022

Korean J Ophthalmol

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“…As compared with conventional blind direct silicone intubation, ENDI reduces complications from false passage formation. This procedure is typically performed under local anesthesia, and it has evolved into a less-invasive and more secure procedure, resulting in its increasingly widespread use in Northeast Asia 16 – 19 . Furthermore, as compared with other ethnical populations, Northeast Asians have relatively flat facial features, with a less elevated superior orbital rim, allowing for relatively easy manipulation of the dacryoendoscope 20 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of the efficacies of 1.0 and 1.5 mm silicone tubes for the treatment of nasolacrimal duct obstruction

Nakamura

Kamao

Mitani

et al. 2022

Sci Rep

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This retrospective observational study analyzed the postoperative outcomes of bicanalicular intubation using different diameters of tube stents for treating postsaccal nasolacrimal duct obstruction. A total of 130 patients diagnosed with postsaccal obstruction who underwent endoscopic-assisted silicone tube intubation were included in the study. Patients intubated with a 1.5-mm large-diameter tube were designated as the LD group, and those with a 1.0-mm normal-diameter tube were designated as the ND group. The patency rates of the two groups at 1 year after tube removal were compared using the Kaplan–Meier curve and restricted mean survival time (RMST) method with τ = 365 days. Results demonstrated that the recurrence rate after tube removal was significantly lower in the LD group as compared with the ND group (p = 0.001). The patency rates at 1 year after removal in the LD and ND group were 85.7% (95% confidence interval [CI]: 75.4, 91.9) and 73.9% (95% CI: 61.7, 82.8), respectively. When comparing the patency rates by the RMST method at τ = 365 days, the RMST difference, RMST ratio, and RMTL ratio were higher in the LD group at p = 0.045, 0.052, and 0.046, respectively.

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“…12 The diagnosis and treatment of lacrimal out ow obstructions using the dacryoendoscope have remarkably increased over the past two decades particularly in East Asia, including Japan, Korea, and the Philippines. [13][14][15][16] East Asians have relatively at facial features, with a less elevated superior orbital rim than other ethnic groups, which may allow relatively easy manipulation of a dacryoendoscope. 17 Another contribution is that the development of bent-tip and curved probes facilitates observation until the end of the nasolacrimal duct in patients who cannot be observed using conventional straight-type probes (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

“…Recanalization surgery using a bent-type dacryoendoscope involves perforating the obstructed site by pushing a catheter capped on the probe's tip and placing a silicone tube stent on the opened lacrimal pathway. [14][15][16]23,24 The consistency of diagnostic results from various examination methods of the LDS is an important question that should be investigated. Then, the medical records of 113 patients underwent syringing, DCG, and dacryoendoscopy to preoperatively evaluate the LDS obstruction.…”

Section: Introductionmentioning

confidence: 99%

The Agreement among Syringing, Dacryocystography, and Dacryoendoscopy in Lacrimal Duct Obstruction

Nakamura

Kamao

Mitani

et al. 2022

Preprint

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Purpose: To retrospectively investigate the agreement of diagnostic findings in syringing, dacryocystography (DCG), and dacryoendoscopy in the obstruction of the lacrimal drainage system (LDS).Design: Retrospective, analytical observational studyMethods: We examined 113 patients (211 LDS) who underwent syringing, DCG, and dacryoendoscopy to preoperatively evaluate LDS obstruction. Obstruction was compared by classifying the obstruction grade and site into three levels, respectively. The diagnostic agreement between tests was assessed by determining the weighted kappa value.Results: A total of 25 male (49 LDS) and 88 female patients (162 LDS) were included in this study. Obstruction was observed in 77.4%, 60.0%, and 81.3% of LDS by syringing, DCG, and dacryoendoscopy, respectively. Regarding the agreement in obstruction grade, Cohen’s kappa value for DCG and dacryoendoscopy was 0.65 (95% confidence interval [CI]: 0.56–0.74). DCG found no obstruction in 38.4% of all LDS, whereas 47.9% of them showed stenosis or obstruction by dacryoendoscopy. Meanwhile, DCG and dacryoendoscopy showed consistency in the obstruction site in 77.9% of LDS. When discrepancies were observed between syringing and dacryoendoscopy to detect the obstruction site, the combination of syringing and DCG reached dacryoendoscopy findings at the 99% level.Conclusions: “Substantial” agreements were found in the diagnostic findings among the three examinations. Then, the highest agreement was observed between syringing and dacryoendoscopy in determining the obstruction site. The lowest agreements were observed between syringing and DCG in diagnosing the obstruction grade and site.

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Long-term Efficacy of Dacryoendoscopy-guided Recanalization and Silicone Tube Intubation

Cited by 12 publications

References 26 publications

Dacryoendoscopic Findings in the Failed Silicone Tube Intubations without Dacryoendoscopy

Dacryoendoscopic Findings in the Failed Silicone Tube Intubations without Dacryoendoscopy

Comparison of the efficacies of 1.0 and 1.5 mm silicone tubes for the treatment of nasolacrimal duct obstruction

The Agreement among Syringing, Dacryocystography, and Dacryoendoscopy in Lacrimal Duct Obstruction

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