Masahiro Fujimoto1,2, Ken Ogino3, Hiroko Matsuyama4, Chika Miyazaki5,6. 1. Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaracho, Sakyou, Kyoto, 606-8507, Japan. m2fjmt@kuhp.kyoto-u.ac.jp. 2. Department of Ophthalmology, Hyogo Prefectural Tsukaguchi Hospital, Hyogo, Japan. m2fjmt@kuhp.kyoto-u.ac.jp. 3. Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaracho, Sakyou, Kyoto, 606-8507, Japan. 4. Department of Ophthalmology, Shizuoka General Hospital, Shizuoka, Japan. 5. Department of Ophthalmology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan. 6. Department of Ophthalmology, Hyogo Prefectural Tsukaguchi Hospital, Hyogo, Japan.
Abstract
PURPOSE: Our aim was to review the success rates of dacryoendoscopy-guided probing for recalcitrant congenital nasolacrimal duct obstruction (CNLDO). METHODS: We reviewed the medical records of 498 patients (521 eyes) diagnosed with CNLDO between January 2011 and November 2013. Of these, 54 eyes met the eligibility criteria and underwent probing with a dacryoendoscope. RESULTS: Of the 54 eyes, 21 were classified as failed cases at other hospitals, 13 as cases requiring conversion from blind to dacryoendoscopy-guided probing during surgery at our hospital, and 20 as cases requiring intervention under general anesthesia because of difficulty with topical anesthesia. The overall success rate with dacryoendoscopy was 98.1 % (53/54 eyes) at postoperative week 2 and 97.1 % (33/34 eyes) a year after surgery. Among the cases that failed at other hospitals, one showed the formation of five false passages in the middle area of the nasolacrimal duct. In 11 eyes, slit-like adhesion was confirmed as a blurred linear line at the distal end of the nasolacrimal duct. Patency could be smoothly achieved by releasing the adhesion. CONCLUSIONS: Our study showed a high success rate for dacryoendoscopy-guided probing in CNLDO patients. The use of a dacryoendoscope allows direct visualization of the lacrimal passage and is likely to become necessary for managing CNLDO.
PURPOSE: Our aim was to review the success rates of dacryoendoscopy-guided probing for recalcitrant congenital nasolacrimal duct obstruction (CNLDO). METHODS: We reviewed the medical records of 498 patients (521 eyes) diagnosed with CNLDO between January 2011 and November 2013. Of these, 54 eyes met the eligibility criteria and underwent probing with a dacryoendoscope. RESULTS: Of the 54 eyes, 21 were classified as failed cases at other hospitals, 13 as cases requiring conversion from blind to dacryoendoscopy-guided probing during surgery at our hospital, and 20 as cases requiring intervention under general anesthesia because of difficulty with topical anesthesia. The overall success rate with dacryoendoscopy was 98.1 % (53/54 eyes) at postoperative week 2 and 97.1 % (33/34 eyes) a year after surgery. Among the cases that failed at other hospitals, one showed the formation of five false passages in the middle area of the nasolacrimal duct. In 11 eyes, slit-like adhesion was confirmed as a blurred linear line at the distal end of the nasolacrimal duct. Patency could be smoothly achieved by releasing the adhesion. CONCLUSIONS: Our study showed a high success rate for dacryoendoscopy-guided probing in CNLDO patients. The use of a dacryoendoscope allows direct visualization of the lacrimal passage and is likely to become necessary for managing CNLDO.