Long-Term Outcomes of External Dacryocystorhinostomy in the Age of Transcanalicular Microendoscopic Techniques.

Purpose. This study aimed to evaluate long-term results of external dacryocystorhinostomy (DCR) at a tertiary eye care center specializing in lacrimal duct surgery in Germany. Methods. The medical records of 1010 patients with acquired nasolacrimal duct obstruction (NLDO), who had undergone lacrimal duct surgery at a tertiary eye care center, were reviewed. Only adult patients who had undergone external DCR were included. The evaluation included the following parameters: age, gender, duration of symptoms, patient satisfaction, previous dacryocystitis, complication rates, and surgical outcome. Results. 154 eyes of 146 patients (14.5%) could be included in the study. The average age was 64.1 ± 29.7 years. 66.4% of patients were females and 33.6% were males. Acute or chronic dacryocystitis was found in 81 patients (55.5%). Overall, 82.8% of patients had full resolution of symptoms. The success rate of external DCR for patients with previous episodes of dacryocystitis was 82.7% compared to 83.4% for patients without dacryocystitis in their medical history. Conclusion. In cases in which transcanalicular microendoscopic techniques are contraindicated (e.g., after dacryocystitis) or in complex cases where microendoscopic procedures have failed (revision surgery), external DCR is still the surgical treatment of choice with very good postoperative success.

[Traumatic Lacrimal Duct Stenosis: Demographics and Success Rate of Surgical Procedures for Secondary Treatment]. / Traumatische Tränenwegsstenosen: Epidemiologie und Erfolgsraten nach sekundärer operativer Intervention.

BACKGROUND: Traumatic lacrimal duct stenosis can be the result of sharp trauma of the eyelid, indirect trauma or surgery in the nasoorbital region, as well as burns, chemotherapy and radiation of the facial region. The aim of the study is to present the demographics, patient satisfaction, and course of different surgical procedures for secondary treatment of traumatic lacrimal duct stenosis. METHODS: We retrospectively reviewed the medical records of 50 patients who required surgery for traumatic lacrimal duct stenosis from 2009 to 2011 at the University Eye Hospital in Muenster. The evaluation included the following criteria: age, sex, duration of symptoms, complication rate and the rate of recurrence. We systematically evaluated the medical data and asked the patients about the recent symptoms via telephone questionnaire. RESULTS: 60 eyes of 50 patients were included (18 women; 32 men; age: 51.8 ± 17.1 years); 34 eyes (56.7 %) had already had operations of the lacrimal system. The success rate was 58.1 %. The mean postoperative follow-up was 52.3 ± 10.7 months. In 11 cases (18.3 %), a dakryocystorhinostomy (DCR) was necessary. CONCLUSION: Traumatic lacrimal stenosis is more common in men, and has a poorer prognosis than lacrimal duct stenosis from other causes.

[Microsurgical Treatment of Canalicular Stenosis: Long-Term Follow-Up]. / Verlauf von Kanalikulusstenosen nach mikroskopischer Kanalikuluschirurgie.

PURPOSE: Studies about the indication and the functional prognosis of microsurgical treatment of canalicular stenosis (CR) are rare. In this study we determined the cause, recurrence and success rates of CR and compared our results with the results in the literature. METHODS: We retrospectively reviewed the medical records of 22 patients who required a microsurgical treatment of canalicular stenosis (CR) from 2009 to 2011. We systematically evaluated the medical data and asked the patients about the recent symptoms via telephone questionnaire. RESULTS: 22 patients were included (73 % women; 27 % men; age: 52.8 ± 19.9 years), 12 (55 %) patients had already had operations. The mean postoperative follow-up was 45 ± 9.2 months. The patients were followed for a minimum of 30 months. The success rate was 58 %. CONCLUSION: In some cases like long localised canalicular stenosis and especially after traumatic lacerations of the lacrimal canaliculi, a microsurgical treatment of canalicular stenosis is required. The aim of this procedure is to restore the lacrimal mucosa continuity so that a spontaneous lacrimal drainage is possible. The success rate of CR in our study was 58 %.