Masashi Mimura1,2,3, Audrey C Ko1,4, Ramzi M Alameddine1,5, Bobby S Korn1, Don O Kikkawa1, Hidehiro Oku2, Bunpei Sato2, Tsunehiko Ikeda2. 1. Department of Ophthalmology, Division of Oculofacial Plastic and Reconstructive Surgery, Shiley Eye Institute, University of California San Diego, La Jolla, California, U.S.A. 2. Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan. 3. Department of Ophthalmology, Osaka Kaisei Hospital, Osaka city, Osaka, Japan. 4. Department of Ophthalmology, University of Iowa, Iowa, U.S.A. 5. Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon.
Abstract
PURPOSE: To report the development and clinical findings of a universal trans-punctal lacrimal microendoscope design. METHODS: In this study, we examined a unique and original "2-bend" (i.e., double-angle) rigid lacrimal microendoscope designed for universal applications for anatomical variations. The shape of endoscope was initially evaluated in 6 lacrimal systems of cadavers (4 Caucasian-cadaver lacrimal systems and 2 Asian-cadaver lacrimal systems). Second, a prospective clinical study involving 45 consecutive cases of nasolacrimal duct obstruction in Japanese patients was conducted to compare the facility and ease of use between the conventional single-bend type and our original 2-bend type trans-punctal lacrimal microendoscope for examination of the lacrimal drainage system. RESULTS: The findings in the cadaver study revealed that original 2-bend lacrimal microendoscope, which was designed double-angled 20°-30° at 10 and 30 mm from the tip of the scope, could more easily used to insert and image all lacrimal systems, while the conventional single-bent lacrimal microendoscope was difficult to insert in subset of patients with a prominent nasal process of the frontal bone. In the clinical trial, our findings showed that 26.7% of lacrimal systems could not be passed using the conventional single-bend design, while using the 2-bend design, all cases could successfully be investigated. CONCLUSIONS: The original 2-bend-design microendoscope was found to be effective and valuable for universal use in examination and evaluation of the lacrimal passage.
PURPOSE: To report the development and clinical findings of a universal trans-punctal lacrimal microendoscope design. METHODS: In this study, we examined a unique and original "2-bend" (i.e., double-angle) rigid lacrimal microendoscope designed for universal applications for anatomical variations. The shape of endoscope was initially evaluated in 6 lacrimal systems of cadavers (4 Caucasian-cadaver lacrimal systems and 2 Asian-cadaver lacrimal systems). Second, a prospective clinical study involving 45 consecutive cases of nasolacrimal duct obstruction in Japanese patients was conducted to compare the facility and ease of use between the conventional single-bend type and our original 2-bend type trans-punctal lacrimal microendoscope for examination of the lacrimal drainage system. RESULTS: The findings in the cadaver study revealed that original 2-bend lacrimal microendoscope, which was designed double-angled 20°-30° at 10 and 30 mm from the tip of the scope, could more easily used to insert and image all lacrimal systems, while the conventional single-bent lacrimal microendoscope was difficult to insert in subset of patients with a prominent nasal process of the frontal bone. In the clinical trial, our findings showed that 26.7% of lacrimal systems could not be passed using the conventional single-bend design, while using the 2-bend design, all cases could successfully be investigated. CONCLUSIONS: The original 2-bend-design microendoscope was found to be effective and valuable for universal use in examination and evaluation of the lacrimal passage.