Revision External Dacryocystorhinostomy Results After a Failed Dacryocystorhinostomy Surgery

Abstract

ObjectiveTo report revision external dacryocystorhinostomy (rE-DCR) results following failed dacryocystorhinostomy (DCR) surgery.MethodsA retrospective review of patients who underwent rE-DCR between June 2006 and June 2015 at Yıldırım Beyazıt University Ankara Ataturk Training and Research Hospital Department of Ophthalmology. Data were collected on the primary surgery technique and patient demographics.ResultsForty-one rE-DCRs were performed on 40 patients after various failed DCR techniques. Two patients had failed DCR twice, and 38 patients had failed DCR once. Six of these previous failed DCRs were multidiode laser DCR, two of them were endoscopic DCR, and 33 were external dacryocystorhinostomy (E-DCR). In all rE-DCR procedures, silicone tube intubation was performed, and the tube was removed at least 6 months after surgery. We used mitomycin C on 16 patients (40%). At the last examination, six patients still had epiphora (15%), and their nasolacrimal passage was obstructed. Thirty-four patients had no complaints, and their passages were open (85%).ConclusionThe rE-DCR procedure has high success rates for failed DCR surgeries, whichever procedure was performed.

Early bi-canalicular silicone stent intubation in failed DCR with endoscopic visualization: a combined approach

“…The aim of this study is to assess the effectiveness of early bi-canalicular silicone stenting in failed cases following DCR surgery. [3][4][5] It was found to be very effective in our study with complete resolution of symptoms following stenting.…”

To Study the Effect of Silicone Tube Intubation with and without Mitomycin C in Revision of Failed Dacryocystorhinostomy Surgery

“…Nam Ju Kim, Were included 40 patients of failed DCR in there study and they performed dcr surgery with silicone tube intubation and concluded that Re DCR has high risk of osteotomy closure, hence this modified technique can be considered as an alternative to standard intubation technique with optimum results [11]. Emine Akcay et al (2016) were included 41 patients of failed DCR surgery in the study and concluded that the repeat external DCR procedure has high success rates for failed DCR surgeries, whichever procedure was performed [12]. Ji Sun Baek et al, (2017) were included 61 patients of failed endonasal DCR surgery and concluded that lacrimal silicone tube intubation is an effective treatment procedure for patients with functional epiphora [13].…”

Endoscopic endonasal balloon-dacryoplasty in failed dacryocystorhinostomy

“…6,7 Overall, END-DCR and EXT-DCR have a technical failure in about 10% of patients, resulting in an inefficient drainage of tears and, consequently, in relapse of watering eye (epiphora). [8][9][10] The most frequent causes of DCR failure is the presence of membranous obstruction of the nasal ostium, formation of granuloma or synechiae next to the neorhinostomy and lacrimal pump disruption. 11,12 Many treatments are available in case of recurrent epiphora after primary surgery, including observation, EXT-DCR, END-DCR and balloon dacryoplasty.…”