Mitomycin C enhanced endocsopic dacryocystorhinostomy

To investigate the safety and efficacy of Mitomycin C enhanced endoscopic dacryocystorhinostom [DCR] in patients with complete nasolacrimal obstruction. Twenty six endoscopic DCR with mitomycin C application were performed in 23 patients between January and May 2004. Of these cases, 5 were males and 18 were females. The mean age was 53 [ +/- 9] years with a range from 28 to 68 years. Only patients with patent canaliculi, normal eye lid function, no suspected lacrimal sac neoplasia, and acquired complete nasolacrimal obstruction due to chronic dacryocystitis and with duration of symptoms for more than 1 year were included in this study. Regular follow up settings were done at l[st] week, then monthly after that to document the patient's subjective improvement, to judge ostium patency on irrigation, and to record any complications. The operation was classified as successful by the subjective disappearance of patient symptoms. A significant success [P < 0.001] was demonstrated in our cohort of patients. The success rate, 6 months after removal of the silicon tube, was 24 [92%] of 26 procedures on subjective basis of disappearance of patient symptoms and 23 [88%] on objective basis as tested by irrigation. No major complications occurred during or after surgery. Mitomycin C enhanced endoscopic DCR is a safe and effective alternative in the management of complete nasolacrimal obstruction. Being efficient, minimally invasive, devoid of any serious complications and safely performed under local anesthesia, it should be considered the DCR procedure of choice

Early experience with endoscopic assisted balloon catheter dacryocystorhiostomy

To conduct a pilot study investigating the safety and efficacy of balloon catheter dacryocystorhinostomy [DCR] in adult patients with acquired complete nasolacrimal obstruction. Nine balloon catheter DCR were performed in 9 patients [2 males and 7 females]. The mean age was 42 [ +/- 9] years with a range from 24 to 59 years. Only patients with patent canaliculi, normal eye lid function, no suspected lacrimal sac neoplasia, and acquired complete nasolacrimal obstruction due to chronic dacryocystitis and with duration of symptoms for more than 1 year were included in this study. Regular follow up settings were done at 1[st] week, then monthly after that to document the patient's subjective improvement, to judge ostium patency on irrigation, and to record any complications. The operation was classified as successful by the subjective disappearance of patient symptoms. A significant success [P < 0.05] was demonstrated in our cohort of patients. The success rate, 6 months after removal of the silicon tube, was 5 [71%] of 7 procedures on subjective basis of disappearance of patient symptoms and objective basis as tested by irrigation. No major complications occurred during or after surgery. Balloon catheter DCR is a simple, safe and effective alternative in the management of simple cases of acquired complete nasolacrimal obstruction in adults. It, provides a new standard in less invasive treatment of complete nasolacrimal duct obstruction and should be considered a first line management when DCR is considered. We do not recommend this technique in complicated cases such as lacrimal fistula and pyoceles since these cases would require a more extensive approaches with removal of the medial sac wall and a considerable widening of the naso-lacrimal osteotomy