Zoramthara Zadeng1, Manpreet Singh, Usha Singh. 1. From the Department of Ophthalmology, Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
PURPOSE: Different techniques have been mentioned in literature for management of idiopathic lacrimal canalicular obstructions. The aim of this study was to report surgical outcomes with use of Sisler's lacrimal trephine and role of Mini-Monoka monocanalicular stent in patients of idiopathic distal canalicular obstructions. DESIGN: This was a prospective, interventional case series. METHODS: Twenty-three patients of idiopathic distal canalicular obstruction were managed surgically from August 2011 to October 2012. Lacrimal canalicular trephination was done in all followed by on-table syringing and Mini-Monoka stent insertion. RESULTS: There were 15 women and 8 men. Mean age of patients was 50.33 ± 12.06 years. Average duration of complaints was 20.58 ± 23.01 months. Twenty-four eyes were included in the study. Common canalicular obstruction was present in 15 eyes (62.5%), whereas 9 (37.5%) had distal lower canalicular obstruction. Mini-Monoka stent was kept in place for a minimum of 8 weeks. Twenty eyes (83.33%) reported absent epiphora, whereas 2 eyes (8.33%) reported improvement at average post-stent removal follow-up of 8.66 ± 3.17 months. No significant complication was observed in intraoperative and postoperative period except for 2 spontaneous tube extrusions, which were managed with tube reinsertion. CONCLUSIONS: Lacrimal canalicular trephination with Mini-Monoka stent insertion is an easy, monocanalicular and lesser invasive technique, which has never been reported earlier in literature. We conclude that this repeatable procedure has good anatomical and functional success rates with minimal complications as compared with the other available treatment modalities for lacrimal canalicular obstructions.
PURPOSE: Different techniques have been mentioned in literature for management of idiopathic lacrimal canalicular obstructions. The aim of this study was to report surgical outcomes with use of Sisler's lacrimal trephine and role of Mini-Monoka monocanalicular stent in patients of idiopathic distal canalicular obstructions. DESIGN: This was a prospective, interventional case series. METHODS: Twenty-three patients of idiopathic distal canalicular obstruction were managed surgically from August 2011 to October 2012. Lacrimal canalicular trephination was done in all followed by on-table syringing and Mini-Monoka stent insertion. RESULTS: There were 15 women and 8 men. Mean age of patients was 50.33 ± 12.06 years. Average duration of complaints was 20.58 ± 23.01 months. Twenty-four eyes were included in the study. Common canalicular obstruction was present in 15 eyes (62.5%), whereas 9 (37.5%) had distal lower canalicular obstruction. Mini-Monoka stent was kept in place for a minimum of 8 weeks. Twenty eyes (83.33%) reported absent epiphora, whereas 2 eyes (8.33%) reported improvement at average post-stent removal follow-up of 8.66 ± 3.17 months. No significant complication was observed in intraoperative and postoperative period except for 2 spontaneous tube extrusions, which were managed with tube reinsertion. CONCLUSIONS: Lacrimal canalicular trephination with Mini-Monoka stent insertion is an easy, monocanalicular and lesser invasive technique, which has never been reported earlier in literature. We conclude that this repeatable procedure has good anatomical and functional success rates with minimal complications as compared with the other available treatment modalities for lacrimal canalicular obstructions.