ABSTRACT
This article describes a technique of dacryocystectomy involving dissection within the subfascial plane, in which the lacrimal sac fascia is preserved and the orbital fat remains undisturbed. The lacrimal sac cavity was directly injected with Tisseel fibrin glue mixed with trypan blue. This led to sac distension and facilitated its separation from surrounding periosteal and fascial attachments. Staining the lacrimal sac epithelium improved definition of the mucosal lining. Transverse sections of the lacrimal sac specimen were histologically analyzed, which confirmed that dissection was completed within a subfascial plane. The technique herein described facilitates en bloc excision of the lacrimal sac without breaching the fascial plane that separates the sac from orbital fat.
ABSTRACT
Purpose: To study the efficacy of dacryocystectomy (DCT) in reducing epiphora in cases of primary acquired nasolacrimal duct obstruction. Methods: This was a prospective, nonrandomized, interventional study conducted over a period of 12 months. All cases who either opted or satisfied our criteria for DCT in primary acquired nasolacrimal duct obstruction (age above 70 years) were included in the study. Patients with secondary nasolacrimal duct obstruction and those undergoing revision surgeries were excluded. Patients were asked to report the percentage improvement in postoperative watering subjectively. Munk score and fluorescein dye disappearance test (FDDT) were recorded pre? and postoperatively. Wilcoxon signed ranked test was used for analysis. Results: Eighty?two eyes of 65 patients were included. Most of the patients (46, 70.8%) were females. The mean age was 68.46 ± 5.7 years (range: 60–85 years). The mean subjective improvement in watering was 86.8%. The P value for preoperative and postoperative difference in Munk score and FDDT score was highly significant (P = 0.00001). Conclusion: Apart from providing relief from ocular discharge, DCT also provides significant improvement in watering. Patients can be preoperatively counseled regarding chances of reduction in epiphora following surgery
ABSTRACT
features of idiopathic orbital inflammatory disease in a young male patient. Clinical features, pathophysiology, and management of lacrimal sac rhinosporidiosis have been discussed.
ABSTRACT
Conjunctivo-dacryocystorhinostomy with the Jones tube has been commonly performed for the management of common canaliculi obstruction. However this procedure necessitates a long-term follow-up because of numerous potential complications. So the authors attempted common canaliculo-dacryocystorhinostomy with silicone tube intubation and the surgical outcomes were evaluated. Common canaliculo- dacryocystorhinostomy with silicone tube intubation was performed in 15 patients, 18 eyes. The patients presented with lacrimal sac mucocele, previous dacryocystectomy or unknown etiology. In 9 eyes 0.04% mitomycin C drops were applied for 1 week postoperatively. After a follow-up period of 6 months to 29 months, 16 eyes (88.9%) of 18 eyes were patent on lacrimal irrigation and 15 eyes (83.3%) showed relief of epiphora. In all of the 9 eyes who had applied mitomycin C showed patency and 7 of the remaining 9 eyes who had not applied mitomycin C showed patency on lacrimal irrigation. As the above results show common canaliculo- dacryocystorhinostomy is an effective method in the management of common canaliculi obstruction and the application of mitomycin C can improve surgical success.