ABSTRACT
BACKGROUND: Lacrimation of the eye is a relatively common problem, the cause of which must be clarified by differential diagnostics. The most important symptom of a dysfunction of lacrimal drainage is epiphora. METHODS: Due to the enhancement and miniaturization of endoscopes, which were originally used in gastroduodenoscopy in the 1990s, it is possible to check the anatomical structure and visualize pathological changes of the lacrimal drainage system, which is only approximately 1 mm in diameter. As shown by the results, mechanical stenoses are often caused by recurrent chronic inflammation. A complete stenosis usually occurs only slowly due to dysregulation of the lacrimal unit. CONCLUSION: In contrast to the assumptions that were valid before the implementation of microendoscopy, complete stenoses are often only punctate and do not stretch over long distances. Shortly after the introduction of microendoscopic diagnostics minimally invasive therapy techniques, such as laser dacryoplasty (LDP) and microdrill dacryoplasty (MDP) were established. These procedures have enabled for the first time preservation of the entire physiology of the lacrimal drainage pump system despite surgical intervention after recanalization.
Subject(s)
Dacryocystorhinostomy/methods , Endoscopy/methods , Lacrimal Duct Obstruction/diagnosis , Lacrimal Duct Obstruction/therapy , Microsurgery/methods , Ophthalmoscopy/methods , Diagnosis, Differential , Evidence-Based Medicine , Humans , Lacrimal Duct Obstruction/congenital , Minimally Invasive Surgical Procedures/methods , Treatment OutcomeSubject(s)
Blepharoplasty/methods , Eyelid Diseases/surgery , Eyelids/abnormalities , Eyelids/surgery , Minimally Invasive Surgical Procedures/methods , Patient Satisfaction , Combined Modality Therapy/methods , Evidence-Based Medicine , Eyelid Diseases/pathology , Eyelids/pathology , Humans , Rhytidoplasty/methods , Treatment OutcomeABSTRACT
PURPOSE: The aim of this study was to evaluate the long-term success rates of a multimodal concept for treating functional nasolacrimal duct obstruction (FNLDO) consisting of minimally invasive lacrimal duct surgery and additional treatment of the conjunctiva, the puncta or the lids if necessary. METHODS: Clinical outcomes and subjective symptoms of 118 consecutive patients with the main diagnosis FNLDO were studied in a retrospective design. RESULTS: Of the 118 cases 64â% were treated by microendoscopy and microdrill only while 36â% needed additional treatments. In 76â% of all cases (82â% in the group of patients who were treated by microdrill only) the patients reported their symptoms to have "improved" after a median follow-up of 14 months. Up to the age of 70 years more women were affected by FNLDO, while it was more common among male patients above this age. In older patients additional treatment especially tightening of the lids was required more frequently. CONCLUSION: Transcanalicular microendoscopy of the lacrimal duct alone or in combination with additional treatments, if needed, showed satisfactory long-term outcomes in patients suffering from FNLDO and can be considered a valuable and minimally invasive option for these patients.
Subject(s)
Dacryocystorhinostomy/methods , Endoscopy/methods , Lacrimal Duct Obstruction/diagnosis , Microsurgery/methods , Minimally Invasive Surgical Procedures/methods , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
Since the introduction of the first coralline hydroxyapatite porous orbital implant as eye replacement in the early 1980s, numerous other modified porous implants have been developed. Due to the different design of the existing studies concerning long-term safety with, in some cases, relatively short follow-up, a comparison is difficult and none of the implant types can be clearly identified as being superior. Factors affecting the exposure rate of the implant seem to be the implant coating, the surgical technique and the condition of the patient's tissue at the beginning of surgery.
Subject(s)
Eye Enucleation/instrumentation , Eye Enucleation/methods , Eye, Artificial , Orbital Implants , Equipment Failure Analysis , Humans , Porosity , Prosthesis DesignSubject(s)
Blepharoplasty , Eyelid Diseases/surgery , Eyelids/surgery , Plastic Surgery Procedures/methods , HumansABSTRACT
Epiphora (tearing) is the main symptom of a dysfunction of the lacrimal drainage. Tearing is a common problem and the cause can not easily be identified. Since development and miniaturisation of gastroduodenal endoscopes in the 1990s, it is possible to check the anatomical structure and the pathological changes of the lacrimal drainage system, which has a diameter of 1 mm. Mechanical stenosis is often caused by recurring chronic inflammation. Complete stenosis is usually only punctual and seldom over a long distance. Shortly after the development of microendoscopic diagnostic tools, therapeutic techniques using a laser for the dacryoplasty (LDP) or a microdrill for the dacryoplasty (MDP) were established. For the first time, these treatments enable preservation of the whole physiology of the lacrimal drainage system in spite of surgical intervention.
Subject(s)
Endoscopy/methods , Lacrimal Apparatus Diseases/pathology , Lacrimal Apparatus Diseases/surgery , Laser Therapy/methods , Minimally Invasive Surgical Procedures/methods , Ophthalmologic Surgical Procedures/methods , HumansABSTRACT
Blepharoplasty of the upper and the lower eyelid is a very common aesthetic procedure of the face and is carried out by different types of surgeons. Before starting the procedure it is very important to analyze all pathogenetic factors. The position of the skin incision is dependent on the extent and position of the element to be corrected and age, sex and racial characteristics should be taken into consideration.
Subject(s)
Blepharoplasty/methods , Blepharoplasty/trends , Eyelid Diseases/surgery , HumansSubject(s)
Blepharoptosis/diagnosis , Blepharoptosis/therapy , Ophthalmology/trends , Germany , HumansABSTRACT
The blepharophimosis ptosis epicanthus inversus syndrome (BPES, also known as Waardenburg syndrome) was probably first reported by Ammon in 1841 and discribed more fully by Vignes in 1889. Its primary effects on the soft tissue of the midface are blepharophimosis, ptosis, epicanthus inversus and telecanthus. It starts with the epicanthic folds at about the age of 3-4 years, followed by the correction of the ptosis about 9-12 months later. Early surgery may be necessary for amblyopia. In 1995 the gene locus was identified as 3Q23. BPES is due to a mutation within a single gene, the FOXL2 gene. In female patients an early childhood ovarian insufficiency must be excluded.
Subject(s)
Blepharophimosis/diagnosis , Blepharophimosis/surgery , Blepharoptosis/diagnosis , Blepharoptosis/surgery , Skin Abnormalities/diagnosis , Skin Abnormalities/surgery , Female , Humans , SyndromeABSTRACT
Transcanalicular microendoscopic diode laser DCR combined with 5-mm balloon dacryoplasty is an innovative procedure in lacrimal surgery. This procedure is minimally invasive and provides the possibility to fill the gap between the first step procedures (LDP, MDP) and external or internal DCR.
