Surgical Outcomes of Canalicular Trephination Combined with Endoscopic Dacryocystorhinostomy in Patients with Distal or Common Canalicular Obstruction.
10.3341/kjo.2015.29.6.368
- Author:
Yoon Jin KONG
1
;
Hye Sun CHOI
;
Jae Woo JANG
;
Sung Joo KIM
;
Sun Young JANG
Author Information
1. Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. ysyat01@naver.com
- Publication Type:Original Article
- Keywords:
Dacryocystorhinostomy;
Lacrimal apparatus disease;
Trephining
- MeSH:
Adult;
Aged;
Dacryocystorhinostomy/*methods;
Female;
Follow-Up Studies;
Humans;
Lacrimal Apparatus/*surgery;
Lacrimal Duct Obstruction/*therapy;
Male;
Middle Aged;
*Natural Orifice Endoscopic Surgery;
Postoperative Complications;
Retrospective Studies;
Treatment Outcome;
Young Adult
- From:Korean Journal of Ophthalmology
2015;29(6):368-374
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study investigated the surgical outcomes of canalicular trephination combined with endoscopic dacryocystorhinostomy (DCR) in patients with a distal or common canalicular obstruction. It also identified the factors affecting surgical success rates associated with this technique. METHODS: We retrospectively reviewed the medical records of 57 patients (59 eyes) in whom a canalicular obstruction was encountered during endoscopic DCR. All patients were treated with endoscopic DCR, followed by canalicular trephination and silicone tube placement. The surgical outcome was categorized as a functional success according to the patient's subjective assessment of symptoms, including epiphora, and as an anatomical success according to a postoperative nasolacrimal duct irrigation test. Surgical success rates were compared based on age, sex, location of the obstruction, number of silicone tubes, and experience of the surgeon. RESULTS: Functional success was achieved in 55 of 59 eyes (93%) at one month, 50 eyes (84%) at three months, and 46 eyes (78%) at six months. Anatomical success was achieved in 58 of 59 eyes (98%) at one month, 52 eyes (88%) at three months, and 50 eyes (84%) at six months. There was a statistically significant difference in surgical outcome according to the experience of the surgeon. The anatomical success rate at the six-month follow-up exam was 95.4% in the >5 years of experience group, and 53.3% in the <5 years of experience group (p = 0.008, Pearson chi-square test). CONCLUSIONS: The success rate of canalicular trephination combined with endoscopic DCR in patients with a distal or common canalicular obstruction decreased gradually during the six-month follow-up period. In particular, patients undergoing procedures with experienced surgeons tended to show excellent surgical outcomes at the six-month follow-up exam.
