Symptom assessment in patients with functional and primary acquired nasolacrimal duct obstruction before and after successful dacryocystorhinostomy surgery: a prospective study

Abstract

In both FNLDO and PANDO populations, symptoms bother patients significantly, and successful DCR surgery has a positive effect on the patient's physical and psychological well-being.

A clinical trial of endoscopic vs external dacryocystorhinostomy for partial nasolacrimal duct obstruction

“…7,14 It is only recently that outcomes from subtotal NDO have been studied distinctly to total obstructions, and they seem to be associated with generally worse surgical outcomes to total blocks (Table 1). [3][4][5]15,6 The first study to highlight this interesting subgroup of patients with partial blocks was a retrospective review of 37 patients with 'functional block' treated with external DCR and estimated a success rate of at least 50%, though criteria for success were different to this study.…”

“…7 On examination, this group of patients usually display slight regurgitation of saline on nasolacrimal syringing. 7 A diagrammatic proforma of the type devised by Malhotra et al 12 was used to document obstruction in the nasolacrimal duct (this study did not include canalicular constrictions). Confirmation using radiological imaging is often advocated including by the American Academy of Ophthalmology, as used in the current study.…”

“…1 Partial NDO accounts for a significant number of patients attending lacrimal clinics, though sufferers may be less likely to be offered ext-DCR surgery in many units as symptoms are purely flow symptoms as opposed to flow (tearing) and volume (mucous/purulent discharge) symptomsFthough these symptoms are often still very marked and cause disabling epiphora. 3,7 Patients with partial NDO typically have watering eyes with variable severity of symptoms unlike those typically associated with complete obstructionFusually tears build up and then discharge onto the cheek rather than watering all the time. 7 On examination, this group of patients usually display slight regurgitation of saline on nasolacrimal syringing.…”

“…3,7 Patients with partial NDO typically have watering eyes with variable severity of symptoms unlike those typically associated with complete obstructionFusually tears build up and then discharge onto the cheek rather than watering all the time. 7 On examination, this group of patients usually display slight regurgitation of saline on nasolacrimal syringing. 7 A diagrammatic proforma of the type devised by Malhotra et al 12 was used to document obstruction in the nasolacrimal duct (this study did not include canalicular constrictions).…”

“…This is a clinically important subgroup of patients who, as symptoms are not as severe as total obstruction, can be less willing to undergo ext-DCR and may be more likely to consider the advantages that EES-DCR offers. 7,8 Second, this study also provides prospective data on the outcome of ext-DCR in this group, which had hitherto been lacking, and is important because the retrospective studies performed thus far have produced conflicting outcome data. The aim of this prospective study was to determine whether EES-DCR is effective in relieving the epiphora in patients with partial NDO.…”