A Case of Acquired Dacryocystocele Treated by Lacrimal Silicone Intubation

PURPOSE: To report a case of an acquired dacryocystocele successfully treated with bicanalicular silicone intubation and to review relating literature. CASE SUMMARY: A 17-year-old girl visited our clinic with tearing of both eyes since birth and a mass on the right medial canthal area for 2 years. A firm, non-tender mass with a well-demarcated border was palpated in the subcutaneous level just inferior to the right medial canthal ligament. Lacrimal irrigation via the lower punctums showed reflux through the opposite punctums without nasal passage in both of her eyes. Computed tomographic scan showed a widening of the right lacrimal sac fossa and bony nasolacrimal canal and a 16 x 18 mm sized cyst-like mass in the right lacrimal sac. The patient was diagnosed with right acquired dacryocystocele associated with bilateral congenital nasolacrimal duct obstructions. After opening of the obstructed common canaliculus using a fine lacrimal probe, silicone intubation was performed. The tearing symptom improved and the mass disappeared during the subsequent follow-up period of 1 year. CONCLUSIONS: When only accompanied by distal nasolacrimal duct obstruction, acquired dacryocystocele can be inferred to be associated with congenital nasolacrimal duct obstruction. Subsequently, bicanalicular silicone intubation can be considered as a treatment of choice.

Correction of Lower Lid Retraction Using Autologous Ear Cartilage Graft

PURPOSE: To evaluate the surgical results of lower eyelid retraction using autologous ear cartilage graft. METHODS: Fifty patients (54 eyes) who received surgical correction of lower eyelid retraction by lower eyelid retractors and conjunctiva recession from the tarsal plate with autologous ear cartilage grafts from March 2002 to July 2010 were evaluated. Medical records were reviewed and clinical characteristics, surgical outcomes, and postoperative complications were analyzed retrospectively. RESULTS: The use of prosthesis due to anophthalmos or microphthalmos (22 eyes) was the most common cause of lower eyelid retraction. The mean postoperative follow-up period was 16.6 months (1-98 months). Lower eyelid retraction was successfully corrected in 52 of 54 eyes. Postoperatively, 2 cases of corneal erosions, 1 case of conjunctival erosion, and 2 pyogenic granulomas developed. Corneal and conjunctival erosions resolved with conservative management and granulation tissues were removed by excision. CONCLUSIONS: Correction of lower eyelid retraction using autologous ear cartilage graft is an excellent surgical procedure with low complication rates for eyelid retraction of various etiologies.