Surgical Results of Modified Dacryocystorhinostomy

PURPOSE: To evaluate the surgical results of endoscopic modified dacryocystorhinostomy (DCR). METHODS: The authors operated on patients with upper punctal and canalicular obstruction associated with nasolacrimal duct obstruction and performed endoscopic modified DCR. One end of a lacrimal tube was passed into the nasal cavity through an excision site of the caruncle and internal ostium and the other end of the tube was inserted into the nasal cavity through a patent punctum and the newly created intranasal ostium. The two ends were tied together in the nasal cavity in modified DCR. RESULTS: The primary success rate of modified DCR was 71.0%. Of the four failed cases, one underwent CDCR using Jones tube. CONCLUSIONS: The author's modified DCR may be a suitable alternative method to CDCR or DCR using monocanalicular silicone tube to relieve epiphora in patients with NLD obstruction associated with upper punctal and canalicular obstruction.

Congenital Punctal Agenesis associated with Syndaotyly in a Family

Authers have experienced congenital punctal agenesis with syndactyly in sister and brother who complained purulent discharge and epiphora. Bilateral upper punctal agenesis, fistulas, and common canalicular obstruction in dacryocystogram were found in a 17 year-old brother. Bilateral upper and lower punctal agenesis was found in a 14 year-old sister. Syndactyly was found in both patients. In familial history, father of patients had syndactyly in upper and lower extremities and complained epiphora. Another sister of patients had experience of lacrimal system surgery. Conjunctivodacryocystorhinostomy using Jones tube was performed in both patients.