Comparison of Dacryocystographic Results Before and After Silicone Intubation in Incomplete Nasolacrimal Duct Obstruction

PURPOSE: To compare the dacryocystographic results before and after silicone tube intubation in partial nasolacrimal duct obstruction. METHODS: Dacryocystography was performed on 33 eyes of 17 patients diagnosed with partial nasolacrimal duct obstruction. The anteroposterior (AP) diameters and the mediolateral diameters of the nasolacrimal ducts intubated at the operation were measured by dacryocystography, before the operation and after silicone tube removal. RESULTS: The mean AP, mediolateral diameter and length of nasolacrimal duct in the group who demonstrated improvement after the operation was 2.32 mm, 1.39 mm, and 17.14 mm before the operation, and 2.40 mm, 1.77 mm, and 17.38 mm after the operation, respectively. The mean AP, mediolateral diameter and length of nasolacrimal duct in the group who demonstrated no symptomatic improvement was 2.06 mm, 1.28 mm, and 17.42 mm before the operation, and 2.75 mm, 1.99 mm, and 18.03 mm after the operation, respectively. The alteration of the nasolacrimal duct size in the group with successful postoperative results compared with unsuccessful postoperative results showed no significant difference. CONCLUSIONS: The nasolacrimal duct showed expansion in size based on dacryocystographic results after silicone tube intubation in partial nasolacrimal duct obstruction. However, the operation results and the alteration of the nasolacrimal duct size based on dacryocystographic results demonstrated no accordance.

Silicone Intubation and Dacryocystographic Finding in Incomplete Nasolacrimal Duct Obstruction

PURPOSE: To assess the relationship between the internal diameter of the nasolacrimal duct and the success rate of silicone tube intubation in incomplete nasolacrimal duct obstruction patients with epiphora. METHODS: Dacryocystography was performed 80 patients with symptoms of epiphora and the anteroposterior (AP) diameters and the lateral diameters of the nasolacrimal ducts were measured. These measurements were compared between the group of patients who demonstrated improvement after the operation, and the group without symptom improvement. RESULTS: The mean length of the nasolacrimal duct in the group with nasolacrimal stenosis was 11.7+/-0.1 mm, the mean lateral diameter was 1.0+/-0.2 mm, and the mean AP diameter was 1.1+/-0.1 mm. The AP diameter of the symptomatic nasolacrimal duct in the group with successful postoperative results was 1.1+/-0.1 mm, and 0.9+/-0.1 mm in the group with unsuccessful results. The group with successful postoperative results had an average of 18.1+/-7.0% stenosis in the side of the eye with nasolacrimal duct stenosis compared with the asymptomatic side, and the group with unsuccessful postoperative results had an average of 34%+/-3.6% stenosis. CONCLUSIONS: In cases with nasolacrimal duct stenosis, the success rate of silicone tube intubation was high when the AP diameter of the nasolacrimal duct was more than 1.1+/-0.1 mm and when the stenosis was less than 18.1+/-7.0% in the symptomatic side compared with the opposite side. These results are expected to help predict the success rates when preoperatively planning silicone tube intubation.

Silicone Intubation and Postoperative Mitomycin Application for Partial Nasolacrimal Duct Obstruction in Adults

PURPOSE: This study nasolacrimal duct (NLD) stenosis in adult, evaluated the clinical results of treatment with topical 0.04% mitomycin C (MMC) eyedrops after silicone tube intubation. METHODS: Prospectively, we analysed the clinical results from 29 eyes of 25 adult patients with epiphora due to NLD stenosis who underwent this procedure. RESULTS: The mean follow-up periods was 9.3 months. Twenty-two eyes (76%) showed no epiphora and complete passing into the cavity by lacrimal irrigation. Four eyes (13.7%) showed intermittent epiphora but improvement relative to preoperative state. Three eyes (10.3%) showed persistent epiphora and no improvement. In total, 26 eyes (89%) showed improvement of symptoms. Complications were silicone tube prolapse in 5 eyes (17.2%) and dacryocystitis in 2 (6.9%) CONCLUSIONS: Silicone tube intubation with topical MMC eyedrops for treatment of patients with tearing due to NLD stenosis is effective, safe and easy. This technique can be tried before DCR if the surgeon has a thorough of nasal cavity anatomy and probing.

Result of Partial Nasolacrimal Duct Obstruction After Silicone Tube Intubation

PURPOSE: In a preliminary series of 36 eyes with partial nasolacrimal duct obstruction, the types of dacryoscintigraphy result were classified and the results of silicone tube intubation were analysed. METHODS: The results of dacryoscintigraphy, performed in 36 eyes of 29 patients with partial nasolacrimal duct obstruction, were classified into the following 3 types: pre-lacrimal sac type, proximal nasolacrimal duct type and distal nasolacrimal duct type. Punctoplasty accompanied by silicone tube intubation was conducted selectively. RESULTS: In dacryoscintigraphy, symptoms improved in 6 eyes among 6 in distal nasolacrimal duct type (100%), 14 eyes among 18 in proximal nasolacrimal duct type (77.8%) and 8 eyes among 12 in pre-lacrimal sac type (66.7%). CONCLUSIONS: We conclude that dacryoscintigraphy predicts the results of silicone tube intubation. Furthermore, silicone tube intubation was effective in proximal nasolacrimal duct type and distal nasolacrimal duct type, but less effective in pre-lacrimal sac type of partial nasolacrimal duct obstruction.