ABSTRACT
BACKGROUND: This study reports the one-year success rate of a new surgical approach to treat symptoms of chronic epiphora and/or mucopurulent discharge refractive to at least six months of medical treatment in patients with permeable lacrimal drainage system (irrigation test). DESIGN: retrospective chart review analysis. PARTICIPANTS: seventeen consecutive patients referred from a private praxis to an eye clinic to treat, by surgery, symptoms of either chronic epiphora (8/17), mucopurulent discharge (7/17), or both (2/17). INTERVENTION: Piffaretti's non-laser transpunctal endoscopic diagnostic/surgical lacrimal drainage procedure (17/17), lacrimal punctoplasty (16/17), conjunctivochalasisplasty (5/17), lateral canthoplasty (1/17), and/or both conjunctivochalasisplasty and lateral canthoplasty (3/17). In the majority of these patients (13/17) partial obstructions within the lacrimal canaliculus (3/17), the ductus nasolacrimalis (7/17), or both (3/17) were observed endoscopically and removed with Piffaretti's lacrimal trephines. MAIN OUTCOME MEASURES: patient's self-assessment of symptom improvement one year after surgery. RESULTS: One year after surgery, 88 % (15/18) of patients had a marked improvement of their symptoms, 64 % (11/17) of them even reporting as being symptom free. When conducted (14/17), irrigation always revealed a permeable lacrimal system (test not performed in a lost-to-follow-up and in two symptom-free patients). CONCLUSIONS: Surgery can be an alternative therapeutic option for patients who have a permeable lacrimal drainage system and suffer from chronic epiphora and/or mucopurulent discharge that do not respond to conventional conservative medical therapies.
