scholarly journals Outcomes of bicanalicular nasal stent inserted by sheath-guided dacryoendoscope in patients with lacrimal passage obstruction: a retrospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomoyuki Kamao ◽  
Xiaodong Zheng ◽  
Atsushi Shiraishi
Keyword(s):  
Observational Study ◽  
Nasolacrimal Duct ◽  
Retrospective Observational Study ◽  
Success Rates ◽  
Surgical Success ◽  
Obstruction Group ◽  
Symptom Scores ◽  
Lacrimal Canaliculus ◽  
Group 2 ◽  
Group 1

Abstract Background The dacryoendoscope is the only instrument that can observe the luminal side of the lacrimal passage with minimal invasiveness. It was developed to treat lacrimal passage obstructions by inserting a bicanalicular nasal stent with sheath-guided bicanalicular intubation (SG-BCI). The purpose of this study was to determine the outcomes of SG-BCI to treat lacrimal passage obstructions. In addition, to determine the effects of SG-BCI treatment on the quality of life. Methods This was a retrospective observational study of 128 patients (mean age 70.9 ± 11.0 years, range 28–93 years) diagnosed with a unilateral lacrimal passage obstruction. There were 73 patients with a nasolacrimal duct obstruction, 37 with a lacrimal canaliculus obstruction, 7 with a lacrimal punctum obstruction, and 11 with common lacrimal canaliculus and nasolacrimal duct obstructions. They were all treated with SG-BCI. The postoperative subjective outcomes were assessed by the answers to the Glasgow Benefit Inventory (GBI) questionnaire and to an ocular specific questionnaire on 6 symptoms including tearing, ocular discharges, swelling, pain, irritation, and blurred vision. The objective assessments were the surgical success rates and the patency at 6 months after the bicanalicular nasal stent was removed. The patients were divided into those with a pre-saccal obstruction, Group 1, and with a post-saccal obstruction, Group 2. The subjective and objective outcomes were compared between the two groups. Results One hundred twenty-four sides (96.9%) had a successful probing and intubation of the lacrimal passage obstruction by SG-BCI. Of the 124 sides, 110 sides (88.7%) retained the patency after the stent was removed for at least 6 months. The GBI total, general subscale, social support, and physical health scores were + 37.1 ± 29.0, + 41.5 ± 30.0, + 28.0 ± 39.4, and + 24.1 ± 37.7, respectively, postoperatively. All of the 6 ocular specific symptom scores improved significantly postoperatively. The postoperative score of tearing improved in Group 1 (P < 0.0001), while the postoperative scores of all symptoms improved significantly in Group 2. Conclusions The relatively high surgical success rates and positive GBI scores, and improved ocular symptom scores indicate that SG-BCI is a good minimally invasive method to treat lacrimal passage obstructions.

scholarly journals Effect of Age on Primary Balloon Dacryocystoplasty and Probing Success in Congenital Nasolacrimal Duct Obstruction

2021 ◽  
Author(s):  
Volkan Dericioğlu ◽  
Mehmet Orkun Sevik ◽  
Sena Sümmen Saçu ◽  
Muhsin Eraslan ◽  
Eren Cerman
Keyword(s):  
Success Rate ◽  
Age Groups ◽  
Nasolacrimal Duct ◽  
Success Rates ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Group 3 ◽  
Group 2 ◽  
Effect Of Age ◽  
Group 1

Abstract Purpose: To compare the success rates of balloon dacryocystoplasty (BDP) and probing as a primary procedure in congenital nasolacrimal duct obstruction (CNLDO) and investigate the effect of age on both procedures.Methods: A total of 135 patients (171 eyes) with simple or incomplete complex CNLDO were included in this retrospective study; complete complex CNLDO cases were excluded. The success rates for primary BDP (118 eyes) and for probing (53 eyes) were compared as overall and among the age groups; Group 1 (12–24 months old), Group 2 (25–36 months old), and Group 3 (> 36 months old).Results: Mean age of the patients was 41.5±27.2 months for primary BDP, and 21.8±10.8 months for probing (p<0.001). Overall success rates for primary BDP and probing were 81.1% (43/53) and 76.3% (90/118), respectively (p=0.481). Success rates for BDP and probing among age groups were, 93.8% and 85.3% in Group 1 (p=0.306), 93.3% and 50.0% in Group 2 (p=0.012), and 63.6% and 27.3% in Group 3 (p=0.052), respectively. Cox regression analysis showed that the median ages were 18 months for probing and 36 months for primary BDP. Poisson regression model showed that, for every one-month increase in patients’ age, the success rate of probing decreased by 9.7%.Conclusion: Probing success decreased to a point where different treatment options such as primary BDP can be discussed with the patient’s parents after 18 months of age. The success of BDP decreased after 36 months, while it maintained a high success rate between 24-36 months as primary treatment.

Viscocanalostomy with Mitomycin-C: A Preliminary Study

2005 ◽  
Vol 15 (2) ◽  
pp. 202-208 ◽  
Author(s):  
A. Yarangümeli ◽  
ö. Gürbüz Köz ◽  
M.N. Alp ◽  
A.H. Elhan ◽  
G. Kural
Keyword(s):  
Mitomycin C ◽  
Long Term Results ◽  
Success Rates ◽  
Surgical Success ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
Conjunctival Bleb ◽  
Group 1

Purpose To compare the results of viscocanalostomy with and without mitomycin-C (MMC). Methods Retrospective results of 15 standard viscocanalostomy (VCO) operations (Group 1) were compared with the prospective results of 15 VCO operations performed with intraoperative adjunctive MMC (Group 2). MMC (0.2 mg/mL) was applied over and under the superficial scleral flap for 3 minutes in Group 2 before the deep flap was prepared. Each patient was followed up for at least 1 year, and results of examinations in the first 12 months were used in the statistical comparison of the two groups. Surgical success was defined as intraocular pressure (IOP) ≤ 18 mmHg. Results Pr eoperative mean intraocular pressures (IOP) in Group 1 and Group 2 wer e 35.3±11.0 and 39.1±8.9, respectively. Mean IOP levels at the 12th month were 14.4±2.6 and 11.9±4.0, respectively, showing a significant decrease in both groups (p<0.001). Postoperative IOP course appeared to be lower in the MMC group, however, the difference was not statistically significant (p=0.554). Complete success rates without medications were 40% in Group 1 and 67% in Group 2. No significant difference was found between the two groups in terms of early and late postoperative complications, pre- and postoperative number of antiglaucoma medications, and surgical success rates at the end of the study period (p>0.05 for all). A significant difference was verified between the two groups of eyes considering the conjunctival bleb types, as low-lying, localized blebs were the most frequent type in Group 1 and thin-walled, avascular blebs were more predominant in the MMC group (p=0.004). Conclusions Intraoperative adjunctive MMC use might improve the long-term results of viscocanalostomy by facilitating subconjunctival filtration and might widen the indication range of the technique.

Surgical treatment of consecutive exotropia: Comparison of different surgical methods applied to one eye in one session

2021 ◽  
pp. 112067212110342
Author(s):  
Nazife Sefi-Yurdakul ◽  
Sibel Oto ◽  
Aysel Pelit
Keyword(s):  
Surgical Treatment ◽  
Success Rates ◽  
Single Session ◽  
Surgical Success ◽  
Group 4 ◽  
Additional Surgery ◽  
Surgical Methods ◽  
Consecutive Exotropia ◽  
Group 2 ◽  
Group 1

Purpose: To compare the different surgical methods performed on a single eye in a single session and the factors that affect the success of patients having consecutive exotropia (XT) developed after esotropia surgery. Methods: The medical data of the patients who underwent surgery for consecutive XT were reviewed retrospectively. Patients with followed of 6 months or more were divided into four groups; patients with medial rectus (MR) advancement (Group 1 = 10), MR advancement and MR resection (Group 2 = 12), MR advancement and lateral rectus (LR) recession (Group 3 = 13), MR advancement, MR resection, and LR recession (Group 4 = 14). Success results and possible risk factors were investigated. Results: Forty-nine patients with consecutive XT (21 female, 28 male) were enrolled in the study. The mean age of overall patients was 22.97 years at surgery for consecutive XT. The groups did not display significant differences in terms of surgery ages, gender, refraction values, visual acuity, amblyopia, inferior oblique overaction, limitation of adduction, surgical success rates, and follow-up time ( p > 0.05). Patients of Group 4 had larger preoperative and postoperative deviation, while Group 1 had smaller ( p < 0.05). The surgical success rates of Groups 1, 2, 3, 4 were 90%, 75%, 76.9%, and 50%, respectively ( p = 0.192). Statistically, no factor was found to be effective in surgical success rates ( p > 0.05). Conclusion: Surgical treatment of consecutive XT is successful in most of the patients with numerous surgical options performed on a single eye in a single session. Patients, particularly with a high amount of deviation should be warned about the possibility of additional surgery.

scholarly journals Analysis of Age as a Possible Prognostic Factor for Transcanalicular Multidiode Laser Dacryocystorhinostomy

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Emre Ayintap ◽  
Ibrahim Bulent Buttanri ◽  
Fariz Sadıgov ◽  
Didem Serin ◽  
Mustafa Ozsutcu ◽  
...  
Keyword(s):  
Success Rate ◽  
Nasolacrimal Duct ◽  
Skin Incision ◽  
Old Patients ◽  
Surgical Success ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Purpose. To assess the prognostic value of age on the outcome of transcanalicular multidiode laser dacryocystorhinostomy (TCL-DCR) in patients with acquired nasolacrimal duct obstruction (NLDO).Methods. The medical records of TCL-DCR performed between March 2009 and September 2013 were reviewed retrospectively. Inclusion criteria include over 20 years of age, similar mean follow-up period, and similar mean duration of stenting. The main outcome is surgical success. The effect of age on success rate is also evaluated.Results. The anatomical success was 52% in Group 1 (20–30 years), 56% in Group 2 (31–40 years), 64% in Group 3 (41–50 years), 76% in Group 4 (51–60 years), and 88% in Group 5 (over 60 years). The statistical difference among Group 1 and Group 5, in terms of surgical success rate, was found to be significant (P=0.009). Additionally, the 20–30-year-old patients had a failure rate 6.76 times higher than that of the over-60-year-old patients (P=0.009; 95% CI, 1.605–28.542).Conclusion. TCL-DCR is a surgical treatment option for NLDO for which a skin incision can be avoided. The success rate of TCL-DCR for younger population is lower when compared with elderly population.

scholarly journals Comparison of Transcanalicular Multidiode Laser Dacryocystorhinostomy with and without Silicon Tube Intubation

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Yildiray Yildirim ◽  
Taner Kar ◽  
Tuncay Topal ◽  
Enver Cesmeci ◽  
Abdullah Kaya ◽  
...  
Keyword(s):  
Diode Laser ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Success Rates ◽  
Duct Obstruction ◽  
Significant Difference ◽  
Silicon Tube ◽  
Silicone Tube Intubation ◽  
Group 2 ◽  
Group 1

Aim. To compare the surgical outcomes of surgery with and without bicanalicular silicon tube intubation for the treatment of patients who have primary uncomplicated nasolacrimal duct obstruction.Methods. This retrospective study is comprised of 113 patients with uncomplicated primary nasolacrimal duct obstruction. There were 2 groups in the study: Group 1 (n=58) patients underwent transcanalicular diode laser dacryocystorhinostomy surgery with bicanalicular silicon tube intubation and Group 2 (n=55) patients underwent transcanalicular diode laser dacryocystorhinostomy surgery without bicanalicular silicon tube intubation. The follow-up period was18.42±2.8months for Group 1 and18.8±2.1months for Group 2.Results. Success was defined by irrigation of the lacrimal system without regurgitation and by the absence of epiphora. Success rates were 84.4% for Group 1 and 63.6% for Group 2 (P=0.011). Statistically a significant difference was found between the two groups.Conclusion. The results of the study showed that transcanalicular diode laser dacryocystorhinostomy surgery with bicanalicular silicon tube intubation was more successful than the other method of surgery. Consequently, the application of silicone tube intubation in transcanalicular diode laser dacryocystorhinostomy surgery is recommended.

Comparing the outcome of Muller’s muscle conjunctival resection for mild/moderate versus severe involutional aponeurotic ptosis

2020 ◽  
pp. 112067212096345
Author(s):  
Senay Asik Nacaroglu ◽  
Gamze Ozturk Karabulut ◽  
Korhan Fazil ◽  
Kubra Serefoglu Cabuk ◽  
Nilay Kandemir Besek ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Success Rates ◽  
Retrospective Case ◽  
Upper Eyelid ◽  
Surgical Success ◽  
Resected Tissue ◽  
Group 2 ◽  
Control Study ◽  
Müller’S Muscle ◽  
Group 1

Aims: To compare predictability of the outcomes of Muller’s muscle conjunctiva resection (MMCR) in patients with severe versus mild/moderate involutional aponeurotic ptosis. Methods: This was a retrospective case-control study. All cases were recruited into the groups in terms of preoperative marginal reflex distance of upper eyelid (MRD-1). Group 1 consisted of patients with mild to moderate blepharoptosis was defined as an MRD-1 equal to 1.1 to 3 mm and Group 2 consisted of patients with severe blepharoptosis defined as MRD-1 ⩽ 1 mm. All patients underwent MMCR based on the response to phenylephrine and the amount of ptosis. MRD-1 obtained both manually and with ImageJ analysis program preoperatively and on the postoperative sixth month was compared. Successful surgical outcome criteria were defined as MRD-1 ⩾ 2.5 mm and inter-eyelid symmetry ⩽ 1 mm. Results: A total of 97 eyes of 83 participants met the inclusion criteria for this study (Group 1 n = 50, Group 2 n = 47). In terms of MRD-1 success rates were 88% in Group 1, and 70.2% in Group 2 ( p = 0.03). Preoperative MRD-1 which was measured by ImageJ, and the amount of resected tissue in mm were the predictive data of surgical outcome by the logistic regression analysis (OR 6.45, 95% CI 1.82–22.78, p = 0.004, OR 2.47, 95% CI 1.05–5.80, p = 0.037, respectively). Conclusion: The surgical success of MMCR can be predicted via tissue resection length and preoperative MRD-1. Higher surgical success rates were obtained in cases with mild-moderate ptosis and clinically acceptable success rates were obtained in cases with severe ptosis.

Systematic, Combined Treatment Approach to Nasolacrimal Duct Obstruction in Different Age Groups

2000 ◽  
Vol 10 (4) ◽  
pp. 324-329 ◽  
Author(s):  
F. Çiftçi ◽  
A. Akman ◽  
M. Sönmez ◽  
M. Ünal ◽  
A. Güngör ◽  
...  
Keyword(s):  
High Pressure ◽  
Conservative Management ◽  
Treatment Approach ◽  
Nasolacrimal Duct ◽  
Success Rates ◽  
Group 4 ◽  
Silicone Intubation ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

PurposeTo report the outcome of a step-by-step treatment approach for congenital nasolacrimal duct obstruction (CNDO).MethodsThree-hundred and fifty eyes with CNDO were included in the study. A number of treatment methods were applied systematically until a successful outcome was achieved. Listed in order from simple to more complex, the following methods were used: conservative management (massage and topical antibiotics), high-pressure syringing, probing, and silicone intubation. Treatment efficacy was determined according to age (Group 1: 0–6 months, Group 2: 7–12 months, Group 3: 13–24 months, Group 4: 25–72 months) and success rates were compared.ResultsConservative management was applied only in children less than 1 year of age, and was successful in 91.8% of Group 1 and 60% of Group 2 eyes. The difference between these two success rates was significant (p = 0.003). High-pressure syringing was performed in children under 24 months of age, with success rates of 41.7% in Group 1, 33.3% in Group 2, and 12.5% in Group 3. The overall success rate for first probing in all groups was 76.1%, with a range of 69.4% to 80.9%. After second probing, the overall cure rate for the entire cohort was 88.0%, with a range of 74.9% to 94.8%. There was no real difference in probing cure rates relative to age (p > 0.05). Silicone intubation was indicated and performed in two eyes of Group 2 children, three eyes of Group 3, and nine eyes of Group 4. Two ducts in Group 4 eyes remained obstructed after silicone intubation.ConclusionsThe systematic treatment approach to CNDO, including conservative management and minimally invasive procedures such as high-pressure syringing, probing, and silicone intubation, is highly successful. In this study, the cure rate for this combined approach was 100% in youngsters under 2 years of age and 94.5% in children 2 to 6 years old.

scholarly journals Non endoscopic endonasal dacryocystorhinostomy versus external dacryocystorhinostomy

1970 ◽  
Vol 6 (4) ◽  
pp. 437-442 ◽  
Author(s):  
BR Sharma
Keyword(s):  
Direct Method ◽  
Case Series ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Successful Outcome ◽  
Success Rates ◽  
Endoscopic Endonasal ◽  
Duct Obstruction ◽  
Surgical Success ◽  
External Dacryocystorhinostomy

Aims and Objectives: To compare the success rates of non endoscopic endonasal dacryocystorhinostomy and conventional external dacryocystorhinostomy for the surgical management of primary acquired nasolacrimal duct obstruction. Materials and methods: A retrospective, nonrandomized, comparative interventional case series of 302 patients who underwent either endonasal or external dacryocystorhinostomy over a period of 2 years. All surgeries were performed by a single surgeon and patients with primary nasolacrimal duct obstruction with a minimum of 6 months post operative follow up were included in the study. While external dacryocystorhinostomy was performed using traditional technique, endonasal dacryocystorhinostomy was performed using direct method of nonendoscopic visualization. Results: Of the 302 cases included in the study 165 patients had endonasal dacryocystorhinostomy whereas 137 underwent external dacryocystorhinostomy. Success was defined by resolution of symptoms of tearing, a negative fluorescein dye disappearance test and patency of the canalicular system on lacrimal irrigation. In the external dacryocystorhinostomy group 124 (90.5%) patients had surgical success whereas 146 (88.5%) of the endonasal dacryocystorhinostomy patients had successful outcome. The overall success rate was 89.4%, and the difference of surgical success between the two groups was not statistically significant ( P=0.57). Conclusion: Non endoscopic endonasal dacryocystorhinostomy gives surgical results comparable to those of external dacryocystorhinostomy and is a viable alternative where dacryocystorhinostomy is indicated for primary acquired nasolacrimal duct obstruction. Key words: Endonasal Dacryocystorhinostomy (ENDCR), External Dacryocystorhinostomy (EXDCR), Primary acquired nasolacrimal duct obstruction (PANLDO)   doi: 10.3126/kumj.v6i4.1731  Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 437-442     

Epiphora in patients after high-dose radioiodine therapy

2021 ◽  
pp. 54-55
Author(s):  
V.D. Yartsev ◽  
◽  
E.L. Atkova ◽  
Keyword(s):  
Radioiodine Therapy ◽  
Therapy Group ◽  
Nasolacrimal Duct ◽  
Positive Answer ◽  
Nasolacrimal Duct Obstruction ◽  
High Dose ◽  
Duct Obstruction ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Purpose. To estimate the frequency of tearing in patients after high-dose radioiodine therapy. Materials and Methods. The survey was conducted in 500 patients after radioiodine therapy (group 1) and 654 volunteers (group 2). We asked whether the respondent noticed epiphora last month, in case of a positive answer we specified how many times during the day it was necessary to wipe the tear, comparing the result with Munk scale. Results. The patients of group 1 noticed tearing in 232 cases, the respondents of group 2 noticed it in 186 cases. Epiphora was more frequent in patients of group 1 (46 % of cases), rather than in volunteers of group 2 (27 % of cases). Excessive tearing was noticed in 8.8 % of patients of group 1 and 3.5 % of respondents of group 2. The difference was statistically significant. Conclusion. 8.8 % of patients complain about excessive tearing after high-dose radioiodine therapy, which is more frequent than in the general population. This may be related to secondary acquired nasolacrimal duct obstruction. Key words: epiphora, nasolacrimal duct obstruction, radioiodine therapy.

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