Management of unsuccessful lacrimal surgery.

Welham, R A; Wulc, Allan E.

doi:10.1136/bjo.71.2.152

Cited by 259 publications

(182 citation statements)

References 9 publications

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“…Confirming the reported data, Welham et al 16 , reviewed 205 failed DCR and concluded that the main cause of failure was incomplete opening of rhinostome and Millman et al 17 observed that fibrotic sacs presented therapeutic failure in 29%, whereas sacs with mucoceles had 82% failure.…”

Section: Discussionmentioning

confidence: 64%

Dacriocistorrinostomia endoscópica

Filho¹,

Voegels

Butugan

et al. 2005

Rev. Bras. Otorrinolaringol.

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Endonasal endoscopic dacryocystorhinostomy (EN-DCR)is now a well-established procedure to relieve nasolacrimal duct obstruction, becoming its domain for the ENT surgeons indispensable. Aim: The aim of the present study is to report the experience of the Otorhinolaryngology Department of the University of São Paulo Medical School in the management of the obstruction of the drainage of the nasolacrimal system by EN-DCR, comparing with the results in literature. Study design: clinical retrospective. Material and Method: We reviewed the medical records of 17 patients (17 eyes) that were submitted to EN-DCR between april 2001 and july 2004. We analysed: sex, age at the time of diagnosis, etiology, clinical findings, surgical technique, use of silicone tubes, follow-up and complications. Results: Eight men and nine women, the age range was from 29 to 79 years (mean 42.6413.1 years), mean follow-up time: 15 months, presented a lacrimal clinic with epiphora. Powered DCR was performed in 06 cases and YAG LASER in 01 patient. Silicone tubes were used in all cases and left in place mean 7.9 weeks. The surgical success rate was 82,3%. Conclusion: EN-DCR showed one safe technique, with advantages in relation to the external technique. So ophthalmologists and ENT physicians must work in harmony to offer more benefits to its patients.

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Section: Discussionmentioning

confidence: 64%

Dacriocistorrinostomia endoscópica

Filho¹,

Voegels

Butugan

et al. 2005

Rev. Bras. Otorrinolaringol.

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“…If the bony ostium is small in a failed DCR, we have increased the size of the same ostium instead of making a new one keeping in mind that the ostium contracts after the operation [21]. The classical teaching on external DCR advises that the bony opening created at surgery be at least 15 mm in A-P diameter [22]. This teaching suggests that all bone between the medial wall of the sac and the nose should be removed leaving approximately an area of 5 mm around the internal punctum free of bone.…”

Section: Discussionmentioning

confidence: 99%

Management of Traumatic Dacryocystitis and Failed Dacryocystorhinostomy Using Silicone Lacrimal Intubation Set

Rizvi

Sharma

Tripathy

et al. 2011

Indian J Otolaryngol Head Neck Surg

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The aim of this work is to study the management and success rate of traumatic dacryocystitis and failed dacryocystorhinostomy (DCR) using Silicone lacrimal intubation set. A prospective study was conducted at a tertiary eye care hospital, India from February 2006 to January 2008. This study material comprised 50 patients of traumatic dacryocystitis and failed dacryocystorhinostomy. Anterior single flap external dacryocystorhinostomy with Silicon intubation was performed in all the patients. The patients were followed up at weekly intervals for 1 month and thereafter every 2 months for 1 year post operatively. Criteria determining success were based on resolution of epiphora and patency on syringing. In traumatic dacryocystitis, 21(91.3%) cases fulfilled these criteria while 23(85.2%) cases of failed DCR were successful. The overall success rate (88%) was determined with an average follow-up of 1 year. Globally, the technique was effective in 85% of cases. The results were comparable with other similar studies. This study concludes that performing a DCR in traumatic dacryocystitis and failed DCR taking into consideration the complications and chances of failure is a challenge for the surgeon. We opine that External dacryocystorhinostomy with Silicon Intubation is one of the most effective modality in dealing with such cases.

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“…Interpreting the current literature on CCO is problematic since previous studies commonly group all distal CCOs together, without clearly distinguishing between membranous and solid types. Furthermore, in the setting of primary DCR, distal canalicular obstruction remains among the most common etiology cited for failure, 1,7,[19][20][21] which in some cases, is because of the fact that the pre-operative evaluation fails to detect a canalicular obstruction before DCR surgery. 2,22 Although careful lacrimal probing and irrigation should reveal the 'soft-stop' in the setting of distal canalicular obstructions, the differentiation from a 'hard-stop' may on occasion be difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Some techniques can be performed in an office setting, while others are used as an adjunct to more invasive lacrimal surgery. [2][3][4][5][6][7][8] In the setting of transnasal endoscopic dacryocystorhinostomy (EnDCR), one previous study has reported retrospective outcomes of trephination for CCOs. 9 To our knowledge, this is the first study that has employed membranectomy without trephination and has attempted to evaluate the outcome of both membranous and more solid distal obstructions of the common canaliculus.…”

Section: Introductionmentioning

confidence: 99%

A prospective outcome study of membranous and solid distal common canalicular obstructions

Shams

Pirbhai

Selva

2016

Eye

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Purpose To prospectively evaluate the surgical outcomes of membranous and solid distal common canalicular obstructions (CCOs) following endoscopic dacryocystorhinostomy (EnDCR) and lacrimal intubation combined with either membranotomy or trephination. Methods This was a prospective, nonrandomized, consecutive interventional case series. Inclusion criteria included patients undergoing EnDCR with evidence of a membranous block or more solid obstruction of the distal common canaliculus, treated with membranotomy or canalicular trephination. Complete CCO was confirmed pre-operatively using dacryocystography and dacryoscintigraphy. All patients received bicanalicular intubation for 3 months with a minimum follow-up of 12 months. Functional and anatomical success was assessed at 4 weeks, 3 months, and 12 months following surgery. Functional success was defined as subjective improvement of epiphora and anatomical success as the presence of a patent ostium and a positive dye test on nasal endoscopy. Results Twenty-nine patients were included in the study with a mean age of 58 years. Twentyone patients (72%) received a membranotomy and eight (28%) required trephination. At 12 months, the functional and anatomical success rate in the membranotomy group was 90% (19/21) and 100% (21/21), respectively, and in trephination group the functional and anatomical success rate was 63% (5/8). There were no intraoperative or lacrimal stent-related complications. Conclusions Identifying and excising distal CCOs in association with EnDCR and lacrimal intubation is associated with a high degree of functional (83%) and anatomical (90%) success. The success of membranous obstructions appear be superior to outcomes for solid obstructions of the distal common canaliculus that require trephination.

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Management of unsuccessful lacrimal surgery.

Cited by 259 publications

References 9 publications

Dacriocistorrinostomia endoscópica

Dacriocistorrinostomia endoscópica

Management of Traumatic Dacryocystitis and Failed Dacryocystorhinostomy Using Silicone Lacrimal Intubation Set

A prospective outcome study of membranous and solid distal common canalicular obstructions

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