Cytopuncture microbiopsy during transcanalicular endoscopic lacrimal duct recanalization: A novel approach

Objective@#To describe the cytopuncture microbiopsy (CM) technique performed during transcanalicular endoscopic lacrimal duct recanalization (TELDR) in patients with primary acquired nasolacrimal duct obstruction (PANDO) as an alternative to open biopsy, the standard method used in collecting specimen.@*Methods@#This is a noncomparative, interventional case series with histopathologic correlation. Patients diagnosed with complete PANDO who underwent TELDR with balloon dacryoplasty and silicone intubation with CM at University of Santo Tomas Hospital from October 2014 to January 2017 were included.@*Results@#Twenty (20) tissue specimens from the lacrimal sac and nasolacrimal duct were obtained from 18 patients. There were 16 females and 2 males included in the study. Mean age was 57.5 years. All specimens revealed few clusters of benign epithelial cells with few degenerated mononuclear cells and lymphocytes, and singly scattered lymphocytes that are set in fibrinous background. Tissue cytology studies were negative for malignant cells.@*Conclusion@#CM is a minimally invasive procedure that offers an alternative to open biopsy technique that can be done routinely during TELDR.

Bilateral frontalis sling for surgical correction of unilateral and bilateral severe congenital ptosis with poor levator function

Objective@#This study evaluated the functional and cosmetic outcomes after bilateral frontalis sling repair using either expanded polytetrafluoroethylene (ePTFE) or silicone rod for unilateral or bilateral severe congenital ptosis with poor levator function.@*Methods@#This was a non-comparative, interventional case series involving 30 patients with unilateral or bilateral severe congenital ptosis who underwent bilateral frontalis sling repair from February 2012 to November 2018. Medical records including pre- and postoperative photographs were reviewed. The functional and cosmetic outcomes were assessed.@*Results@#There were 15 patients with severe congenital ptosis who underwent ePTFE surgery and 15 patients who had silicone rod surgery. Baseline levator function measured was less than 5 mm in all patients. The mean follow-up duration after surgery was 15.6+6.9 months. Satisfactory eyelid contour was observed in all patients (100%). Postoperatively, all had good to excellent primary eyelid position and effective frontalis action on eyelid elevation. Complications included exposure of the silicone sling material after trauma at the brow area (n=1) and recurrence of ptosis (n=2).@*Conclusion@#Bilateral frontalis suspension in patients with severe congenital ptosis, whether bilateral or unilateral, resulted in excellent functional and cosmetic outcomes using ePTFE or silicone rod.

Surgical technique and preliminary results of transcanalicular endoscopic lacrimal duct recanalization and balloon dacryoplasty with silicone intubation in Filipino patients with complete nasolacrimal duct obstruction

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To describe the surgical technique of transcanalicular endoscopic lacrimal duct recanalization (TELDR) with balloon dacryoplasty and silicone intubation in patients with complete nasolacrimal duct obstruction and assess their effectivity.</p> <p style="text-align: justify;"><strong>METHODS:</strong> Ten lacrimal systems from eight patients diagnosed with complete nasolacrimal duct obstruction (NLDO) underwent TELDR and balloon dacryoplasty with silicone intubation.</p> <p style="text-align: justify;"><strong>RESULTS:</strong> All 10 lacrimal systems from eight patients who underwent TELDR and balloon dacryoplasty with silicone intubation had 100% anatomical and functional patency.</p> <p style="text-align: justify;"><strong>CONCLUSION:</strong> TELDR and balloon dacryoplasty with silicone intubation represents an alternative, minimally invasive technique in the management of complete nasolacrimal duct obstruction.</p>