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- Title
Dacryoendoscopic surgery and tube insertion in patients with common canalicular obstruction and ductal stenosis as a frequent complication.
- Authors
Kazuhisa Sugiyama
- Abstract
Abstract Purpose To report the performance of a new technique and strategy for treating common canalicular obstruction (CCO). Since ductal stenosis is a frequent complication of CCO, access to the whole lacrimal passage is important for CCO treatment. Methods In a retrospective, nonrandomized clinical trial, 46 patients (57 CCO cases, 42–93 years old) were treated with either dacryoendoscopic canalicular incision (EI) dacryoendoscope-guided tube insertion (EGT), EI plus inferior meatal dacryocystorhinostomy (iDR)/EGT, EI plus endonasal dacryocystorhinostomy (enDCR), or external canaliculo-DCR depending on the degree of ductal stenosis. The dacryoendoscope was used for incisional positioning, examination and guidance. Results Ductal stenoses/obstructions were complicated in 14 of 57 CCO cases (24.5%). The success rate after 6–25 months of postoperative follow-up was 89.5% (51/57 cases). The success rates after EI/EGT alone, EI plus enDCR, and EI/EGT plus iDR were 90.4% (38/42 cases), 100% (4/4 cases), and 90% (9/10 cases), respectively. In one case, false passages through the submucosa of the canaliculi were identified, and the surgical approach was converted from EI/EGT to canaliculo-DCR. Conclusions: EI/EGT alone is an effective, minimally invasive method for treatment of simple CCO. Additional lacrimal surgery (iDR/EGT, enDCR, and canaliculo-DCR) is effective for complicated CCO
- Subjects
ENDOSCOPIC surgery; LACRIMAL apparatus surgery; LACRIMAL apparatus diseases; STENOSIS; CLINICAL trials; POSTOPERATIVE period; DISEASE complications
- Publication
Japanese Journal of Ophthalmology, 2009, Vol 53, Issue 2, p145
- ISSN
0021-5155
- Publication type
Article