Results of Silicone Tube Intubation in Patients with Common Canalicular Obstruction in Dacryocystography

PURPOSE: To evaluate the effects of silicone tube intubation in patients showing common canalicular obstruction in dacryocystography. METHODS: We conducted a retrospective chart review of 136 eyes of 93 patients who underwent silicone tube intubation and who were followed for more than 6 months. The patients were divided into 2 groups: the normal canaliculus group (112 eyes of 72 patients) and the common canalicular obstruction group (24 eyes of 21 patients). The demographic characteristics, degree of nasolacrimal duct obstruction on probing, and functional and anatomical success rates of silicone tube intubation were compared between the two groups. Surgery success was noted when the patient was satisfied with the 'improved' tearing symptom and the tear meniscus height decreased. RESULTS: On probing, 17 (70.8%) of 27 eyes revealed definite obstructive feeling at nasolacrimal duct in the common canalicular obstruction group, and there was no significant difference compared to the normal canaliculus group (p = 0.639). The anatomical success rate of silicone tube intubation was 91.1% in the normal canaliculus group and 83.3% in the common canalicular obstruction group, and the functional success rate was 85.7% in the normal canaliculus group and 75.0% in the common canalicular obstruction group. There were no significant differences in success rates between the two groups (p = 0.271, p = 0.161, respectively). CONCLUSIONS: Silicone tube intubation can be considered as a primary treatment option for management of common canalicular obstruction.

The Result of Canaliculodacryocystorhinostomy with Double Probing in Common Canalicular Obstruction

PURPOSE: To evaluate the results of endoscopic canaliculodacryocystorhinostomy with double probing to resolve common canalicular obstruction. METHODS: A total of 47 patients (56 eyes) with common canalicular obstruction underwent endoscopic canaliculodacryocystorhinostomy. The double probing method was applied to 28 eyes; the remaining 28 eyes were in the control group. The success rate, degree of symptom improvement, and complication rate of the two groups were compared and analyzed. RESULTS: The postoperative success rate was 96% in the group that underwent surgery with the double probing method and 86% in the control group (P=0.160). The rate of symptom improvement without tearing was 86% in the double probing method group and 61% in the control group (P=0.038). Postoperative complication rates such as granuloma formation were 7% and 29% in the study and control groups, respectively (P=0.036). CONCLUSIONS: Endoscopic canaliculodacryocystorhinostomy with double probing to resolve common canalicular obstruction is proven to be effective in enhancing patient satisfaction and lowering complication rates, with no additional costs and risks.

The Surgical Results of Endonasal DCR with Two Silicone Tubes in Common Canalicular Obstruction

PURPOSE: To evaluate the surgical results of endonasal dacrocystorhinostomy with two silicone intubation in common canalicular obstruction. METHODS: Forty patients (57 eyes) who complained of tearing due to common canalicular obstruction underwent endonasal dacryocystorhinostomy. In this study, We randomly divided patients into two groups. One group underwent one-silicone tube intubation (29 eyes, group A) and the other group underwent two-silicone tube intubation (28 eyes, group B). After surgery, we compared the success rates and the causes of surgical failure between the two groups. RESULTS: There were no significant differences between the two groups with regard to age, sex, duration of silicone intubation, or follow-up time. The primary success rates of the group A and the group B were 65.5% (19/29) and 85.7% (24/28) [(P=0.078)], respectively. the final success rates after the revisional surgery were 76.4% (21/29) and 92.8% (26/28) [(P=0.043)] respectively. Primary causes of surgical failure in the group A were: membranous obstruction of the internal ostium (6), common canalicular re-obstruction (2), sump syndrome (1), and functional obstruction (1). The main causes of surgical failure in the group B were: membranous obstruction of the internal ostium (2), and granuloma formation (2). CONCLUSIONS: We believe that endonasal dacryocystorhinostomy with two-silicone tube intubation might be an excellent alternative treatment modality in order to improve success rates in common canalicular obstruction.

Ballooning Canaliculoplasty and Silicone Tube Intubation after Lacrimal Trephination

PURPOSE: The purpose of this study was to assess the satety and effectiveness of lacrimal trephination and balloon dilatation in treatment of obstruction of the lacrimal canaliculus. METHODS: Lacrimal trephination and subsequent balloon dilation was performed in 7 eyes of 7 consecutive patients with epiphora due to lacrimal canalicular obstruction and common canalicular obstruction. RESULTS: The average age of patients was 50.3 years old and the average follow-up period was 17.7 months. Anatomical success was 7 of 7 eyes (100%) and functional success , resolution of epiphora was 5 of 7 eyes (71%) CONCLUSIONS: Lacrimal trephination and subsequent ballooning canaliculoplasty in treatment of obstruction of the lacrimal canaliculus seems to be safe and valuable as an primary procedure before Jones tube bypass surgery.

Canalicular Trephination with Lacrimal Trephine and Endoscopic DCR

PURPOSE: The purpose of this study is to evaluate surgical outcomes of canalicular trephination with lacrimal trephine and endoscopic dacryocystorhinostomy in patiens with common canalicular or canalicular obstruction. METHODS: 35 patients (38 eyes) diagnosed as common canalicular or canalicular obstruction undergoing surgery between December 1999 and August 2003. Patients have been followed up more than 5 months after surgery. RESULTS: The average age of patients was 57.3 years old and the average follow-up period was 7.1 months. The overall success rate was 92.1%. With obstructions within lower canaliculus, the success rate was 75.0%. The success rate of the cases with obstructions within upper canaliculus and upper and lower canaliculus was 100%, and the success rate of the cases with obstructions within common canaliculus was 95.2%. CONCLUSIONS: The surgical success rate of canalicular trephination with lacrimal trephine and endonasal dacryocystorhinostomy was better than canaliculodacryocystorhinostomy and this seems to be adequate as an primary procedure before Jones tube bypass surgery.

Silicone Intubation for Canalicular or Common Canalicular Obstruction in Adult

PURPOSE: Patients with canalicular or common canalicular obstruction have been treated by carrying out conjuctivodacryocystorhinostomy mainly through skin or the nasal cavity, but all sorts of defects attendant on an operation have been indicated. At this, the authors inquired into a result of a surgery and their satisfaction in a different viewpoint for silicone intubation. METHODS: We inquired into a result of a surgery and their satisfaction in a different viewpoint for 68 patients' 72 eyes who can be observed over 3 months among patients diagnosed as canalicular or common canalicular obstruction and operated on with silicone intubation as subject. RESULTS: After surgery, silicone tube was removed at average postoperative 5.8 months and we observed them for average 10.5 months. The result of operations showed that successful cases are 72.2% (52 eyes) and failing cases are 28.8% (20 eyes). CONCLUSION: For the cases with canalicular obstruction, especially common canalicular obstruction for short period, primary silicone intubation would be one of the ideal lacrimal surgery that should be explained the possible secondary conjuctivodacryocystorhinostomy later.

Treatment of Common Canalicular Obstruction Using Lacrimal Trephine

Conjunctivodacryocystorhinostom.y using Jones tube has been the treatment of choice for patients with epiphora due to common canalicular obstruction. But this procedure carries a lot of disadvantages including external scar formation and many complications result from general anesthesia, and necessity of permanent prosthesis and long-term follow-up. So authors have used a new instrument, the lacrimal trephine designed for creating an opening through 8 distally occluded lacrimal canaliculus to treat the common canalicular obstruction. From June 1996 to December 1996, we performed 8 lacrirnal trephination with silicone tube insertion in five patients diagnosed as common canalicu-lar obstruction. All of them have achieved the anatomical success and four of thein have shown clinical success.