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.

The Clinical Evaluation of Congenital Lacrimal Fistula

PURPOSE: To evaluate the surgical results and clinical characteristics of congenital lacrimal fistula. METHODS: Fourteen patients were diagnosed with congenital lacrimal fistula and received simple fistulectomy. Three patients received anterior lamella reposition operation simultaneously due to epiblepharon. We retrospectively reviewed the medical records and conducted telephone interviews. RESULTS: In 15 eyes of the 14 patients, epiphora through lacrimal fistula disappeared. Two eyes of 2 patients showed a little epiphora only outdoors but there was no need of further treatment. All patients accepted the surgical results cosmetically. Histologically, stratified squamous epithelial change with keratinization was remarkable by aging. In adults, hair follicles with increased keratinization were contained and the result with skin was similar. CONCLUSIONS: Simple fistulectomy was a useful technique for congenital lacrimal fistula.