The Result of Byon's Test in Incomplete Nasolacrimal Duct Obstruction

PURPOSE: To assess the threshold of draining capacity, we performed Byon's test in patients complaining epiphora with incomplete nasolacrimal duct obstruction. METHODS: We measured the draining capacity by using Mclntyre R cannula in 54 patients (98 eyes) from February to December 2000. Through the cannula inserted to lacrimal sac we instilled distilled water for 1 minute at the height of 1.3 meter, then we counted the amount of fluid dropped. RESULTS: The mean values of draining capacity were 2.42+/-0.92 cc/min in men, 2.20+/-0.90 cc/min in women (2.25+/-0.91 cc/min in total). These were lower than normal value by about 48% and the difference was statistically significant (P<0.0001). The highest values in each group were 3.53 cc/min in men, 3.45cc/min in women. Epiphora developed when the draining capacity decreased under the 79% of normal capacity. CONCLUSIONS: This study supports the previous theory that incomplete nasolacrimal duct obstruction may progress to complete obstruction. We hope for another convenient and accurate method for quantitative measurement of lacrimal drainage capacity which will be positioned as a basic test of ophthalmology.

Lacrimal Passages Injury Associated With Eyelid Burns

PURPOSE: To develop a protocol for treatment of injuries to lacrimal punctum and canaliculus associated with eyelid burns. METHODS: We retrospectively reviewed the records of seven patients who required the treatment of punctal and canalicular injuries caused by medial eyelid burns. RESULTS: Four patients were treated with punctoplasty and bicanalicular silicone tube intubation within 3 weeks of injury. One patient was treated at 2 months and punctum of upper eyelid was not found, requiring punctoplasty and monocanalicular silicone tube intubation of lower eyelid. Silicone tube removal was performed over a range of 3 to 6 months. Two patients were treated after 3 months of injury by conjunctivodacryocystorhinostomy. Six patients showed good passage by syringing after surgery. CONCLUSIONS: Early evaluation and treatment of canalicular burn injuries can avoid complex surgical procedures such as conjunctivodacryocystorhinostomy, and silicone tube removal is recommended before 6 months after surgery.

The Clinical outcome of Probing and Silicone Tube Intubation for Congenital Nasolacrimal Duct Obstruction

PURPOSE: We studied the clinical outcome of nasolacrimal probing according to the age and silicone tube intubation for congenital nasolacrimal duct obstruction. METHODS: We analyzed a total of 76 patients (99 eyes) who had undergone nasolacrimal duct probing performed in the office under topical anesthesia and 18 patients (20 eyes) who had undergone silicone tube intubation under general anesthesia between February 1997 and March 2001. Patients who had undergone probing were grouped according to their age at the time of probing: 6 months or less (group 1), 7 to 12 months (group 2) and 13 months or older (group 3). RESULTS: The overall success rate by probing was 84%. The success rate of probing in those under 6 months of age was 88%; in those from age 7 to 12 months, 86%; and in those 13 months or older, the rate decreased to 76%. The decrease in success rate after 13 months was statistically significant (P<0.05). The success rate of silicone tube intubation was 95%. CONCLUSION: We concluded that early office probing under 12 months of age for congenital nasolacrimal duct obstruction is an effective method for treatment of symptomatic nasolacrimal duct obstruction. In case over 13 months of age, probing is also considered as the first choice of treatment although its success rate is lower than the former. Silicone tube intubation is an effective method in case of failure of repeated probing and over 20 months of age.

The Lysozymal Concentration in Tear Film of Contact Lens Us ers

The contact lens wearers are exposed to the risk of permanent visual dysfunction due to various ocular diseases, especially corneal infections. And ocular disease of contact lens wearers are reported to be closely related to the biochemical alterations of tear film. To compare the lysozyme concentration of reflex tear in normal subjects and contact lens wearers, the tear was collected from 38 eyes of 38 normal subjects and 34 eyes of 34 contact lens wearers. The age of the subjects were between 20 to 39 years. The mean concentration of tear lysozyme were 3.55 +/-0.9 6 milligram/milliliter in normal subjects and 3.66 +/-1.02 milligram/milliliter in contact lens wearers. There was no statisti-cally significant difference between the two groups[p>0.05 ]. Though contact lens wearing does not decrease the concentration of tear lysozyme, it seems that this protein serves as a mediator of corneal infection by adhering to the surface of the contact lenses.

Efficacy of Colorado Needle in Lid Surgery

Eyelid has rare infection and good wound healing due to rich blood supply, but often lead to excessive bleeding during surgery. Thus, bleeding control in time of operation is very important to secure operation field and minimize subcutaneous hemorrhage and edema after operation. Retrospectively, we analized intra- and post-operative complications of 92 patients who had undergone eyelid surgeries by one operator using Colorado patients who had undergone eyelid surgeries by one operator using Colorado dissection needle attached to monopolar electrocautery from March to October 1997. there were 49 patients of epiblepharon or entropion, 16 patients of ptosis, 10 patients of dermatochalasis and 17 patients of blepharoplasty. In all 92 patients who had be used with Colorado needle neither complications nor side effects were developed. Therefore, we consider that the colorado needle monopolar electrocautery is an useful instrument in eyelid surgery.

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.