Nasolacrimal Ostium after External Dacryocystorhinostomy

ABSTRACT

PURPOSE: To evaluate the internal ostium and lacrimal sac change after external dacryocystorhinostomy (DCR) using digital subtraction dacryocystography (DCG). METHODS: Between May 2003 and July 2004, digital subtraction DCG was performed to assess the ostium and lacrimal sac 6 months after external DCR in 48 patients (n=50 eyes). RESULTS: The lacrimal sac had reformed in 45 (90%) eyes. Mean ostium size was 2.4 mm (0.5~6.1 mm) and these were located at the inferior part of the reformed sac in 39 eyes (78%). Patients with a fistula-type internal ostium, of which the lacrimal sac had not reformed, often complained of epiphora (p=0.005). CONCLUSIONS: Digital subtraction DCG showed successful anatomic changes in the distal lacrimal pathway and confirmed that the internal ostium contracts into a relatively small ostium after DCR. A fistula-type internal ostium may explain the pathophysiology of functional failure after successful DCR.