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AIM: To compare the effect of different courses of budesonide nasal spray on the postoperative efficacy of endoscopic dacryocystorhinostomy.METHOD: Prospective study. A total of 90 patients(90 eyes)with chronic dacryocystitis who underwent endoscopic dacryocystorhinostomy in our hospital from January 2019 to April 2022 were selected, and they were randomly divided into three groups. In group A, 30 patients(30 eyes)continued to use budesonide nasal spray for 2mo after surgery; in group B, 30 patients(30 eyes)continued to use budesonide nasal spray for 3mo after surgery; in group C, 30 patients(30 eyes)continued to use budesonide nasal spray for 4mo after surgery. Follow-up for 6mo after surgery, Lund-Kenndey score, surgical efficacy and complications of the three groups were compared.RESULT: At 3, 4 and 6mo after surgery, the Lund-Kenndey score of group C was lower than that of group A(P<0.05), and there was no statistical difference between group C and group B(P>0.05). Following up to 6mo, the surgical efficacy of group C was better than that of group A, and the incidence of complications was lower than that of group A(P<0.05); There was no statistically significant difference in efficacy and complications between group C and group B(P>0.05).CONCLUSION: Budesonide combined with endoscopic dacryocystorhinostomy has acceptable efficacy in the treatment of chronic dacryocystitis. After 3mo of treatment, inflammation can be well controlled, which can reduce the occurrence of postoperative complications and improve the effective rate of surgery. However, increasing the treatment course cannot further improve the effective rate of surgery.
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AIM: To investigate the efficacy and safety of dacryocystorhinostomy(DCR)through nasal endoscope with extended bone window and high ostomy in the treatment of chronic dacryocystitis.METHODS: Retrospective clinical study. A total of 50 patients(59 eyes)diagnosed with chronic dacryocystitis in our hospital from January 2018 to January 2020 were selected. They were divided into two groups according to the operation method, with 23 cases(29 eyes)in the simple stoma group and 27 cases(30 eyes)in the improved group. Patients in the simple stoma group were treated with transnasal endoscopic flat middle turbinate axillary DCR(simple stoma), and patients in the improved group were treated with transnasal endoscopic extended bone window with high-level stoma DCR. The total clinical efficiency, postoperative complication rate and satisfaction of the two groups were compared.RESULTS: The effective rate of the simple stoma group was 79% at 12mo after surgery, while that of the improved group was 97%(P=0.039). The total incidence of complications in the simple stoma group was 28%, while that in the improved group was 7%(P=0.042). The satisfaction rate of the simple stoma group was 65%, while that of the improved group was 93%(P=0.030).CONCLUSION: The treatment of chronic dacryocystitis with transnasal endoscopic extended bone window and high-level ostomy DCR further improved the efficiency of surgery and reduced the incidence of complications.
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@#AIM: To explore the effect of nasal septum deviation(NSD)on the curative effect of endonasal endoscopic dacryocystorhinostomy(EES-DCR).<p>METHODS: Totally 84 patients(84 eyes)who have been diagnosed with chronic dacryocystitis in our hospital from June 2017 to May 2019 were collected and then the patients were divided them into two groups according to whether NSD existed through the preoperative nasal endoscopy. Group A included 42 patients(42 eyes)who had no NSD while Group B included 42 patients(42 eyes)who had NSD(mild or moderate). The EES-DCR was performed under general anesthesia in both groups. The preoperative treatment indexes, evaluative efficacy after 6mo follow up and nasal adhesion were compared between the two groups after operation.<p>RESULTS: The operation time and intraoperative blood loss of group B(69.9±13.1min, 51.8±16.4mL)exceeded group A(53.4±11.7min, 24.9±12.0mL)respectively(<i>P</i><0.05), while the hospitalization time between two groups showed no difference(<i>P</i>>0.05). Follow up for 6mo: the effective rate of group A was 86% while group B was 71%(<i>P</i>>0.05); No nasal adhesion was found in group A while 12% incidence existed in group B, with no difference between the two groups(<i>P</i>>0.05).<p>CONCLUSION: Patients who have chronic dacryocystitis combined with mild or moderate NSD do not need to perform a septoplasty simultaneously if the symptom does not accompany by nasal dysfunction. Only by performing the EES-DCR can achieve a quite good result.
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@#AIM: To analyze the difference of the angle between the long axis of lacrimal sac and bony nasolacrimal duct(BNLD)in patients with chronic dacryocystitis and normal eyes, and discuss the relationship between the angle and chronic dacryocystitis.<p>METHODS:A total of 218 patients(248 diseased eyes)from Sichuan Province who visited the ophthalmology department of our hospital from January 2016 to March 2019 were collected retrospectively. All patients underwent computed tomography dacryocystography(CT-DCG)immediately after bilateral lacrimal duct irrigation, and three-dimensional reconstruction of the nasolacrimal duct structure was performed. The structures of the nasolacrimal duct, lacrimal sac and its surrounding tissues were observed in the coronal position, and the lacrimal sac-BNLD angles of the diseased eyes and the normal eyes were measured respectively.<p>RESULTS:The lacrimal sac-BNLD angle of the diseased eyes \〖23.55°(17.30°, 29.90°)\〗 was higher than that of the normal eyes \〖20.05°(15.40°, 28.35°)\〗(<i>P</i><0.05). Among them, the angle of the diseased eyes in female patients \〖24.60°(17.75°, 31.00°)\〗 was significantly higher than that in normal eyes \〖21.15°(15.10°, 27.35°)\〗(<i>P</i><0.05), while there was no significant difference in the angle between the diseased eyes and normal eyes in male patients(<i>P</i>>0.05). In addition, the angle of the diseased eyes in the age group of 41-60 a \〖25.20°(17.90°, 33.00°)\〗 was significantly higher than that in normal eyes \〖21.60°(15.25°, 29.05°)\〗(<i>P</i><0.05).<p>CONCLUSION: The angle between the long axis of lacrimal sac and bony nasolacrimal duct increased in patients with chronic dacryocystitis, which may be one of the factors causing the onset of chronic dacryocystitis in middle-aged and elderly women.
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Background: Congenital Dacryocystitis occurs due to the congenital blockage of the nasolacrimal duct, which results from incomplete canalization of the nasolacrimal duct. It is a significant cause of ocular morbidity in children. When not treated early, complications such as recurrent conjunctivitis, acute on chronic dacryocystitis, lacrimal abscess and fistula formation can occur. It is also a threat to the integrity of the eye by becoming the source of infection to orbital cellulitis and panophthalmitis. In the era of antibiotic resistance, the microbiological workup of congenital dacryocystitis is very useful for subsequent treatment. Aim of the study was to determine the microbial profile of congenital dacryocystitis and the appropriate antimicrobial agents based on the sensitivity pattern of the isolated microorganisms.Methods: A total of 25 clinically diagnosed cases of dacryocystitis in children less than 5 years of age attending the outpatient department were included in the study. Samples were collected from these patients and processed by standard microbiological techniques. All the bacterial isolates obtained were subjected to antimicrobial susceptibility testing by using Kirby-Bauer disc diffusion method.Results: Culture positivity was noted as 56% in this study.' It is observed that Gram-positive bacteria were the predominant isolates of 86%. The predominant organism isolated was Streptococcus pneumoniae 43%, followed by Staphylococcus aureus 29%, Staphylococcus epidermidis 14% and Pseudomonas aeruginosa 14%. All Gram-positive organisms were highly sensitive to Gatifloxacin and least sensitive to Ciprofloxacin. All Gram-negative organisms were highly sensitive to Tobramycin and least sensitive to Ciprofloxacin and Gentamicin.Conclusions: Streptococcus pneumoniae was the common pathogen in congenital dacryocystitis. Gatifloxacin and Tobramycin are the most effective drugs. Microbial culture and sensitivity should be performed in all dacryocystitis cases. This would contribute to the choice of appropriate and effective antimicrobial agents.
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Background: Endoscopic dacryocystorhinostomy (DCR) has become accepted as a suitable treatment for patients with chronic dacryocystitis. In this study authors did endoscopic dacrocystorhinosomy using a microdebrider, which is a recent advancement tool being used successfully in other endoscopic sinus surgeries also. Limited studies are available as of now on this topic.Methods: A total number of 33 patients (with 40 affected eyes) presenting with complains of epiphora having nasolacrimal duct obstruction were selected. They underwent an endoscopic DCR in which dissection of some nasal mucosa and widening of bony ostium was done using a microdebrider. Silicone stent was passed into the nasolacrimal duct through both punctum. Patient outcome was assessed by using both objective (endoscopy and dye test) and subjective (improved symptoms) criteria. Standard follow up time for clinical course was kept 3 months with weekly visits.Results: Patients which got relief from epiphora in 37 eyes (92.5% cases) had no obstruction on endoscopy and positive dye test. Rest (7.5 % cases) had presence of granulation tissue at rhinostoma site and negative dye test, which was cited as the cause of failure.Conclusions: The use of microdebrider is potentially beneficial in endoscopic endonasal dacryocystorhinostomy. By using such an instrument, the minimal amount of tissue damage occurs, a large fistula is formed, and the recurrence due to the formation of adhesions/synechiae/granulations is prevented/reduced thus reducing the time of surgery, complications and failure rate.
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@#AIM: To discuss the advantage, improvement, safety and effectiveness of improved endoscopic dacryocystorhinostomy in the treatment of chronic dacryocystitis.<p>METHODS: Eighty cases of chronic dacryocystitis with two different surgical methods were randomly selected and divided into common endoscopic dacryocystorhinostomy(80 cases with 82 eyes)and improved endoscopic dacryocystorhinostomy(80 cases with 84 eyes)according to operation. Compared to observe cure rate, improvement rate, total effective rate and patient satisfaction of two kinds of surgery by the last follow-up.<p>RESULTS: The cure rate, improvement rate, total effective rate and satisfaction rate were respectively 75.6%, 17.1%, 92.7% and 73.8% for Group A, 90.5%, 5.9%, 96.4% and 92.5% for Group B. Differences between the cure rate, improvement rate and total effective rate between two groups had statistical significance(<i>P</i><0.05).<p>CONCLUSION: The cure rate and improve symptom of improved endoscopic dacryocystorhinostomy is superior to the common endoscopic dacryocystorhinostomy, safe and effective.
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@#AIM: To explore the value of Lund-Mackay score in the surgical treatment of chronic dacryocystitis with chronic sinusitis.<p>METHODS: Totally 92 cases(92 eyes)of chronic sinusitis with chronic dacryocystitis in our hospital from May 2016 to March 2019 were included in the prospective, single-blind study. According to Lund-Mackay score, the patients were divided into three groups: mild(22 cases), moderate(34 cases)and serious(36 cases). Each group was randomly divided into simultaneous operation group and phased operation group. We compared the operative effect and complications of simultaneous and phased operations.<p>RESULTS: In patients with mild and moderate chronic sinusitis combined with chronic dacryocystitis, there was no statistical difference in the efficiency and complications between simultaneous and phased operations(<i>P</i>>0.05). In patients with severe chronic sinusitis combined with chronic dacryocystitis, the efficiency of phased operations was higher than that of the simultaneous surgery(94% <i>vs</i> 61%, <i>P</i><0.05), and the complications were lower than that of the simultaneous surgery(<i>P</i><0.05). <p>CONCLUSION: According to Lund-Mackay score, patients with mild to moderate chronic sinusitis and chronic dacryocystitis are advised to undergo simultaneous surgery, while patients with severe rhinosinusitis are advised to undergo phased surgery.
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@#AIM: To analyze the curative effect and safety of modified dacryocystorhinostomy with simple anterior flap anastomosis in the treatment of chronic dacryocystitis.<p>METHODS: A total of 99 patients(113 affected eyes)with chronic dacryocystitis who underwent dacryocystorhinostomy in the hospital between March 2016 and July 2018 were enrolled in the retrospective study. They were divided into the traditional group(traditional dacryocystorhinostomy, 46 cases, 52 affected eyes)and the modified group(modified surgery with simple anterior flap anastomosis, 53 cases, 61 affected eyes)according to the surgical procedures. The surgical results, rates of granulation tissue formation around the anastomotic stoma at different time after surgery, rates of nasal mucosal epithelialization, size of the anastomotic stoma, the occurrence of surgical complications and the recurrence rate during 1a of follow-up were compared between the two groups.<p>RESULTS: The grade of curative effect in the modified group was better than the traditional group(75.0% <i>vs </i>95.1%)during 6mo of follow-up(<i>P</i><0.05). The total cure rate was higher than that of the traditional group(<i>P</i><0.005). The rates of granulation tissue formation(3.8%, 5.7%, 9.4%)in the modified group at 1mo, 3mo and 6mo after surgery were lower than those in the traditional group(64.2% <i>vs</i> 39.1%, <i>P</i><0.001). The rate of nasal mucosal epithelialization in the modified group was higher than that in the traditional group(25.63±4.76 <i>vs </i>11.34±3.52mm2, <i>P</i><0.01)at 1mo after surgery. The area of anastomotic stoma in the modified group was larger than that in the traditional group(25.63±4.76 <i>vs </i>11.34±3.52mm2,<i>P</i><0.01)at 6mo after surgery. The incidence rates of postoperative hemorrhage and complication in the modified group and the recurrence rate in 1y of follow-up were lower than those in the traditional group(<i>P</i><0.05).<p>CONCLUSION: The cure rate of patients undergoing modified dacryocystorhinostomy with simple anterior flap anastomosis is higher than those undergoing traditional surgery. The former can promote nasal mucosal epithelialization, maintain the size of anastomotic stoma and prevent the formation of surrounding granulation tissue. It is safe and effective, with few complications and low recurrence rate.
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@#Chronic dacryocystitis(CD)is a disease caused by microorganism infection secondary to nasolacrimal duct stenosis or obstruction. Its pathological changes are of great significance to the diagnosis, treatment and prognosis of patients. This paper summarizes the characteristics of the pathological changes of the lacrimal drainage system and surrounding tissues by reading a large number of domestic and foreign literatures on chronic dacryocystitis in recent years, aiming at improving clinicians' understanding, doing better diagnosis, treatment and prognosis judgment, and providing ideas for further research.
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@#AIM: To investigate the clinical effect of laser-assisted endoscopic dacryocystorhinostomy combined with stent intubation in treatment of chronic dacryocystitis. <p>METHODS:Totally 30 cases(32 eyes)of chronic dacryocystitis were selected between January 2014 to June 2016, all of them were treated with laser-assisted endoscopic dacryocystorhinostomy combined with mitomycin C and stent intubation. The stent was moved at 6wk after surgery in generally. The clinical effect was observed. <p>RESULTS: After 6-15mo of follow-up, 28 eyes were cured(88%), 3 eyes were improved(9%), and 1 eye was ineffective(3%). The total effective rate was 97%. <p>CONCLUSION: Laser-assisted endoscopic dacryocystorhinostomy with stent intubation is effective and safe in the treatment of chronic dacryocystitis.
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@#AIM: To explore the value of Lund-Mackay score in the surgical treatment of chronic dacryocystitis with chronic sinusitis.<p>METHODS: Totally 92 cases(92 eyes)of chronic sinusitis with chronic dacryocystitis in our hospital from May 2016 to March 2019 were included in the prospective, single-blind study. According to Lund-Mackay score, the patients were divided into three groups: mild(22 cases), moderate(34 cases)and serious(36 cases). Each group was randomly divided into simultaneous operation group and phased operation group. We compared the operative effect and complications of simultaneous and phased operations.<p>RESULTS: In patients with mild and moderate chronic sinusitis combined with chronic dacryocystitis, there was no statistical difference in the efficiency and complications between simultaneous and phased operations(<i>P</i>>0.05). In patients with severe chronic sinusitis combined with chronic dacryocystitis, the efficiency of phased operations was higher than that of the simultaneous surgery(94% <i>vs</i> 61%, <i>P</i><0.05), and the complications were lower than that of the simultaneous surgery(<i>P</i><0.05). <p>CONCLUSION: According to Lund-Mackay score, patients with mild to moderate chronic sinusitis and chronic dacryocystitis are advised to undergo simultaneous surgery, while patients with severe rhinosinusitis are advised to undergo phased surgery.
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@#AIM: To analyze the curative effect and safety of modified dacryocystorhinostomy with simple anterior flap anastomosis in the treatment of chronic dacryocystitis.<p>METHODS: A total of 99 patients(113 affected eyes)with chronic dacryocystitis who underwent dacryocystorhinostomy in the hospital between March 2016 and July 2018 were enrolled in the retrospective study. They were divided into the traditional group(traditional dacryocystorhinostomy, 46 cases, 52 affected eyes)and the modified group(modified surgery with simple anterior flap anastomosis, 53 cases, 61 affected eyes)according to the surgical procedures. The surgical results, rates of granulation tissue formation around the anastomotic stoma at different time after surgery, rates of nasal mucosal epithelialization, size of the anastomotic stoma, the occurrence of surgical complications and the recurrence rate during 1a of follow-up were compared between the two groups.<p>RESULTS: The grade of curative effect in the modified group was better than the traditional group(75.0% <i>vs </i>95.1%)during 6mo of follow-up(<i>P</i><0.05). The total cure rate was higher than that of the traditional group(<i>P</i><0.005). The rates of granulation tissue formation(3.8%, 5.7%, 9.4%)in the modified group at 1mo, 3mo and 6mo after surgery were lower than those in the traditional group(64.2% <i>vs</i> 39.1%, <i>P</i><0.001). The rate of nasal mucosal epithelialization in the modified group was higher than that in the traditional group(25.63±4.76 <i>vs </i>11.34±3.52mm2, <i>P</i><0.01)at 1mo after surgery. The area of anastomotic stoma in the modified group was larger than that in the traditional group(25.63±4.76 <i>vs </i>11.34±3.52mm2,<i>P</i><0.01)at 6mo after surgery. The incidence rates of postoperative hemorrhage and complication in the modified group and the recurrence rate in 1y of follow-up were lower than those in the traditional group(<i>P</i><0.05).<p>CONCLUSION: The cure rate of patients undergoing modified dacryocystorhinostomy with simple anterior flap anastomosis is higher than those undergoing traditional surgery. The former can promote nasal mucosal epithelialization, maintain the size of anastomotic stoma and prevent the formation of surrounding granulation tissue. It is safe and effective, with few complications and low recurrence rate.
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Purpose: External dacryocystorhinostomy (DCR) surgeries are cost-effective with excellent success rates. The present study was designed to compare the safety and efficacy of conventional external DCR versus external DCR using Pawar silicone implant in chronic dacryocystitis. Methods: This is a prospective, comparative, interventional case series over a period of 18 months with patients managed by external DCR surgery with and without Pawar implant. Institutional review board approval was obtained before the study. The success of the surgery was objectively measured by sac patency on syringing at the last follow up. Results: A total of 65 patients with chronic dacryocystitis were included in the study. The mean age of patients in the series was 41.43 years (median, 41 years; range, 12 years-60 years). All patients presented with epiphora (100%) and underwent external DCR and were chosen for conventional surgery (n = 33, 51%, group 1) or Pawar silicone implant surgery (n = 32, 49%, group 2) on a random basis. The mean duration of the surgery from the time of skin incision to skin closure for group 1 was 27.7 minutes (median, 26 minutes; range, 21-30 minutes) while in group 2, it was 75.5 minutes (median, 75 minutes; range, 60-88 minutes), which was statistically significant (P < 0.01). The success rate of the procedure done in group 1 was 90% which increased to 97% after the management of failed cases as compared to the success rate in group 2 of 91% and 94%, before and after the management of failed cases, respectively. Conclusion: External DCR using Pawar implant is a safe surgery which is faster than conventional external DCR with almost equal success rates between both the procedures.
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@#AIM: To investigate the best time for indwelling catheter of patients with chronic dacryocystitis after lacrimal drainage tube implantation.<p>METHODS: Totally 143 eyes of 143 patients with chronic dacryocystitis after lacrimal drainage tube implantation were selected in our hospital. They were divided into 3 groups including group A(50 eyes of 50 cases)with indwelling catheter in 9wk after tube implantation, group B(57 eyes of 57 cases)with indwelling catheter in 12wk after tube implantation, and group C(36 eyes of 36 cases)with indwelling catheter in 6wk after tube implantation. The clinical efficacy, visual acuity, incidence of epiphora, recurrence rate and incidence of postoperative complications with followed-up among three groups were compared.<p>RESULTS: On the day of extubation, the total effective rates of the three groups were 94%, 93% and 39%, the difference was statistically significant(<i>P</i><0.0167). The total effective rates of group A and group B were better than those of group C, and the difference was statistically significant(χ2=30.830, 32.056, <i>P</i><0.001). At 3mo after extubation, the total effective rates of the three groups were 56%, 51% and 36%, there was no significant difference(χ2=3.454, <i>P</i>=0.178). At 3mo after extubation, there was no significant difference in the visual acuity and the incidence of epiphora among the three groups(<i>P</i>>0.05). At 6mo after extubation, the recurrence rates of the three groups showed no significantly different(<i>P</i>=0.056). The incidence of postoperative complications in three groups were 4%(2/50), 7%(4/57)and 25%(9/36), the difference was statistically significant(χ2=11.048, <i>P</i>=0.004). The incidence of postoperative complications in group C was higher than that in groups A and B(χ2=6.499, 5.934; <i>P</i>=0.011, 0.015).<p>CONCLUSION: The clinical benefits of 6wk and 9wk after lacrimal drainage tube implantation are better than that of 12wk.
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@#AIM: To compare the intraoperative bleeding and the postoperative therapeutic effect of two nasal mucosal incisions in nasal endoscopic dacryocystorhinostomy.<p>METHODS: Retrospective study. Sixty-three patients(66 eyes)with chronic dacryocystitis diagnosed by ophthalmology and treated by nasal endoscopic dacryocystorhinostomy in our hospital from June 2016 to May 2018 were collected. According to the different grouping of the base of nasal mucosal flap, dacryocystorhinostomy was performed through nasal mucosal incision with middle turbinate axilla as base in group A, and dacryocystorhinostomy was performed through nasal mucosal incision with maxillary line as base in group B. The patients were followed up to 6mo after operation, and the intraoperative bleeding and postoperative efficiency were compared between the two groups.<p>RESULTS: There was significant difference in intraoperative bleeding between the two groups.(χ<sup>2</sup>=11.803, <i>P</i><0.05). The postoperative efficiency of patients in the two groups was not statistically significant(82% <i>vs</i> 73%, <i>P</i>>0.05).<p>CONCLUSION: The nasal mucosal incision with the middle turbinate axillary region as the base was associated with more bleeding during the operation, while the nasal mucosal incision with the maxillary line as the base was less bleeding during the operation, and there was no significant difference in the postoperative treatment effect.
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·Chronic dacryocystitis is often seen in middle-aged and old women,especially in menopause. The opening of the obstruction of the nasolacrimal duct is the key to the treatment of chronic dacryocystitis. At present, surgical treatment is the main type of operation. The commonly used methods include the transnasal canthus skin dacryocystorhinostomyandtheendoscopic dacryocystorhinostomy. With the development of technology, the application of laser technology and new lacrimal duct silicon rubber tube makes the clinical treatment of chronic dacryocystitis more perfect. Lacrimal endoscope technology can obtain more intuitive image of lacrimal duct data, to determine the nature, location and degree of obstruction of lacrimal passage and treatment plan is particularly important, is a major breakthrough in the field of diagnosis and treatment of lacrimal duct obstruction,diagnosis and treatment method is currently the most advanced in the field.
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AIM: To investigate the effect of indwelling time of lacrimal silicone drainage tube on chronic dacryocystitis and its effect on visual acuity.?METHODS: The clinical data of 92 patients ( 110 eyes ) with chronic dacryocystitis treated with lacrimal drainage tube in our hospital from January 2013 to December 2016 were retrospectively analyzed. According to the indwelling time, the patients were divided into 6wk group (42 patients 50 eyes ) and 12wk group ( 50 patients 60 eyes). Comparison of two groups on clinical efficacy, vision, overflow symptoms, complications and recurrence was taken.?RESULTS:The effective rate was significantly higher in the 6wk group than in the 12wk group (P<0. 05). The visual acuity and incidence of epilepsy symptoms at 3mo after extubation was not signifcantly different (P<0. 05). The incidence of complication was 14. 0％ (7/50) at 3mo after extubation in 6wk group and significantly lower than that in the 12wk group which was 38. 3％ (23/60, P<0. 05). The recurrence rate was 2. 0％ (1/50) in the 6wk group, which was significantly lower than that in the 12wk group (18. 3％, 11/60;P<0. 05).?CONCLUSION: The clinical efficacy of lacrimal silicone drainage tube for 6wk and 12wk is similar to patients with chronic dacryocystitis. There is also little difference in the visual acuity of patients with dacryocystitis, but with the prolongation of the lacrimal duct drainage tube, rinse patency rate, increase the difficulty of extubation, complications and recurrence rate, the clinical situation should be based on the patient as much as possible to shorten the lacrimal duct silicone drainage tube retention time.
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@#AIM: To observe the clinical effects of modified endoscopic dacryocystorhinostomy(EDCR)for chronic dacryocystitis and try to find out an effective adjuvant method to improve the long-term effect of the modified surgery.<p>METHODS: Totally 136 cases(158 eyes)of chronic dacryocystitis were enrolled in the study and randomly divided into two groups:treatment group(80 eyes)and control group(78 eyes).The treatment group underwent the modified EDCR(intraoperative mytomycin C combined with silicone tube implatation and the use of tobramycin and dexamethasone eye ointment).The control group was only applyed mytomycin C during EDCR.The postoperative follow-up period was for 3-12mo.<p>RESULTS: At 6mo postoperatively,the cure rate and total effective rate of the treatment group were 95.0%, 98.8% respectively,and the control group of it were 75.6%, 93.6%.The effective rate of the treatment group was higher than that of the control group significantly(<i>χ</i><sup>2</sup>=11.90,<i>P</i><0.05).<p>CONCLUSION: The modified EDCR is a new surgical method which can prevent postoperative cicatricial adhesion and elevate surgical effective rate, and it has clear field, minimal invasion, quick recovery, exact effect and less recurrence.
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@#AIM: To study the clinical effect of modified dacryocystorhinostomy for chronic dacryocystitis. <p>METHODS: A retrospective analysis was conducted in our hospital from February 2014 to January 2016 including 168 patients(168 eyes)with chronic dacryocystitis. <p>According to the difference of treatment for patients we established two groups, the observation group of 87 cases underwent modified dacryocystorhinostomy treatment, 81 cases in the control group underwent the conventional dacryocystorhinostomy. Perioperative indexes, lacrimal patency and complication rate of two groups were compared. <p>RESULTS: The operative time, hospitalization time and bleeding amount of the observation group were significantly less than those of control group(<i>P</i><0.05). The total efficiency of the observation group was significantly better than that of the control group, while the postoperative complication rate and recurrence rate were significantly less(<i>P</i><0.05).<p>CONCLUSION: The modified dacryocystorhinostomy is easy to operate, the operation time is short, the complications are few, the curative effect is accurate, it is the effective surgical method for the treatment of chronic dacryocystitis.