The Effectiveness of Lacrimal Trephination for the Treatment of Canalicular Obstruction

PURPOSE: To determine the effectiveness of lacrimal trephination to treat canalicular obstruction. METHODS: Silicone intubation following lacrimal trephination was performed in 38 eyes of 29 patients with epiphora due to canalicular obstruction between December 2005 and October 2009. Medical records were retrospectively reviewed and telephone interviews were performed. The severity of epiphora was graded by Munk's scale, and anatomical improvement was evaluated by postoperative probing and syringing. RESULTS: The procedure was successful in 73.7% of the cases (grade 0 or 1), and 68.4% of the eyes had complete resolution of epiphora (grade 0). The anatomical success rate was 81.6%. CONCLUSIONS: Lacrimal trephination is a simple and effective treatment for canalicular obstructions. Therefore, lacrimal trephination could be performed prior to attempting an invasive conjunctivodacryocystorhinostomy.

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.

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.