The Results of Revisional Surgery for the Failed Endonasal DCR

ABSTRACT

PURPOSE: This large case study evaluated the success rate of revisional surgery and the causes of failed endonasal dacryocystorhinostomy (DCR) with long-term follow-ups. METHODS: One hundred nine patients (114 eyes) who underwent revisional surgery for a failed endonasal DCR at the Department of Ophthalmology, Guro Hospital, Korea University between January 1995 and January 2005 were included in this retrospective study. We evaluated the causes of failed endonasal DCR and their success rates of revisional surgeries. RESULTS: The causes of surgical failure were membranous obstruction (83 eyes), granuloma (22 eyes), synechia (11 eyes), common canalicular obstruction (11 eyes), functional block (7 eyes), and canalicular obstruction (1 eye). The revisional surgeries were silicone tube intubation after granuloma removal, synechiolysis and membranectomy using NdYAG laser and trephination of canalicular obstruction, and endonasal conjunctivodacryocystorhinostomy (CDCR) for the parts of functional block and the canalicular obstruction. The overall success rates of the revisional surgeries were 83.3% (95/114 eyes). The mean follow-ups period was 18.97 months (range, 9~113 months). CONCLUSIONS: This is the first large case study in Korea on revisional surgery with long-term follow-ups, as far as we know. The overall success rates of endonasal DCR after receiving simple revisional surgery were comparable to those of the standard external DCR.