Clinical Experience of Lacrimal Surgery

The success rate of endonasal lacrimal surgery have been reported inferior to that of external lacrimal surgery. But nowadays, owing to developement of surgical instrument, such as endoscope, and improvement of surgical skill, better success rates have been reported. We have performed endonasal lacrimal surgery in 36 eyes of 34 patients and external lacrimal surgery in 41 eyes of 36 patients who have had lacriaml pathway obstruction confirmed by dacryocystography. Endonasal lacrimal surgery has been performed with endoscope, fiberoptic light pipe, and conventional lacrimal surgery instruments. Primary success rates are 84.0% in endonasal dacryocystorhinostomy (DCR), 89.5% in external DCR, 81.8% in endonasal conjunctivodacryocystorhinostomy(CDCR), and 90.9% in external CDCR. The rate of postoperative complications are 32.0% in endonasal DCR, 47.4%, in external DCR, 27.3% in endonasal CDCR, and 40.9% in external CDCR. Therefore, in order to increase the success rate of endonasal lacrimal surgery, improvement of surgical technique, use of adequate surgical instrument and careful followup examination for proper management of postoperative complicaitons are considered essential.

Progressive Iris Atrophy

Progressive iris atrophy is a disease characterized by marked iris atrophy, iris hole, corneal endotherial abnormality, perripheral anterior synechia, and glaucoma. It is considered as a variant of iridocorneal endotherial syndrome with Chandler's syndrome and Cogan-Reese syndrome. We have experianced a 34 year old male patient complaning visual blurring in his left eye. At examination, we found characteristics of progressive iris atrophy. After filerring surgery, associated glaucoma was well controlled. Then we report a case with review of the literatures.