Comparison of the Efficacies of 0.94 mm and Double Silicone Tubes for Treatment of Canalicular Obstruction.

PURPOSE: To compare the clinical effects of the single wide-diameter bicanalicular silicone tube and the double bicanalicular silicone tube in endonasal dacryocystorhinostomy (DCR) with canalicular trephinization for canalicular obstruction. METHODS: We retrospectively reviewed the records of 121 patients with monocanalicular or common canalicular obstruction who had undergone endonasal DCR with random bicanalicular insertion of either double silicone tubes (insertion of two tubes into each canaliculus) or a single wide-diameter (0.94 mm) silicone tube. The tubes were removed at around 3 months after surgery. RESULTS: This study included 79 eyes of 61 patients in the double-tube intubation group and 68 eyes of 60 patients in the single wide-diameter tube intubation group. Anatomical success, evaluated by syringing, was achieved in 72 of the 79 eyes (91.1%) in the double-tube intubation group and 60 of the 68 eyes (88.2%) in the single wide-diameter tube intubation group. Functional success was achieved in 65 of the 79 eyes (82.3%) in the double-tube intubation group and 61 of the 68 (89.7%) eyes in the single wide-diameter tube intubation group. There were no significant differences in the success rates of surgery between the two groups. One patient in the double-tube intubation group underwent conjunctivodacryocystorhinostomy (CDCR) and two in the wide-diameter tube intubation group underwent CDCR or reintubation to treat recurrence. CONCLUSIONS: Intubation using a single wide-diameter tube during endonasal DCR is as effective as double-tube intubation for the treatment of canalicular obstruction, with a lower rate of complications such as inflammation or patient discomfort.

Preoperative Computed Tomography Findings for Patients with Nasolacrimal Duct Obstruction or Stenosis.

PURPOSE: To identify and analyze the role of preoperative computed tomography (CT) in patients with tearing symptoms with nasolacrimal duct obstruction (NLDO). METHODS: We retrospectively reviewed the medical records and CT results on 218 patients who complained of tearing symptoms with NLDO between January 2014 and December 2014. All patients were recruited from Kim's Eye Hospital's outpatient clinic and assessed by clinical history, examination, and CT to evaluate periocular pathology and nasolacrimal drainage system. Patients with abnormal findings assessed by preoperative CT were further reviewed. RESULTS: CT was performed on 218 patients (average age, 58.2 ± 11.9 years). Of these, 196 (89.9%) had endonasal dacryocystorhinostomy, 14 (6.4%) declined surgery, and 8 (3.7%) were inoperable due to abnormal CT findings. Soft tissue opacity was the most common finding which 243 cases (85.9%) of 283 obstructed nasolacrimal duct and 89 cases (81.7%) of 109 non-obstructed nasolacrimal duct showed it. Thirty-nine (17.8%) of 218 patients showed either maxillary sinusitis or ethmoidal sinusitis and 32 (14.7%) of 218 patients presented with periocular inflammation. Other abnormal CT findings included septal deviations, previous fractures, masses, and structural abnormalities of nasal cavity. CONCLUSIONS: Preoperative CT imaging is useful in the assessment of both nasolacrimal drainage and nearby anatomical structures. This information will be helpful in planning surgical interventions and management of NLDO.

Comparison of Surgical Outcome Between Quickert Suture and Quickert Suture With Modified Lateral Tarsal Strip in Involutional Lower Eyelid Entropion.

PURPOSE: To evaluate the surgical outcome between Quickert suture and Quickert suture with modified lateral tarsal strip in involutional lower eyelid entropion. METHODS: A retrospective study was performed on 76 patients (94 eyes) who had undergone Quickert suture (Group 1) and on 38 patients (44 eyes) who had undergone Quickert suture with modified lateral tarsal strip (Group 2) for correction of involutional lower eyelid entropion from January 2011 to December 2013. RESULTS: In Group 1, recurrence rate is 25.5% (24 eyes) and mean duration to recurrence is 11.9 months in Group 1. For correction of recurrence, Quickert suture is performed in 50% (12 eyes), Quickert suture with lateral tarsal strip is performed in 37.5% (9 eyes), and lateral tarsal strip is performed in 12.5% (3 eyes). In Group 2, recurrence rate is 9.1% (4 eyes). For correction of recurrence, lower eyelid retractor reinsertion is performed in 50% (2 eyes), Quickert suture with lateral tarsal strip is performed in 25% (1 eye), and Quickert suture is performed in 25% (1 eye). CONCLUSIONS: Recurrence rate is lower in patients who had undergone Quickert suture with modified lateral tarsal strip than in a patient who had undergone Quickert suture for correction of involutional lower eyelid entropion.