Objective: To describe the cytopuncture microbiopsy (CM) technique performed during transcanalicular endoscopic lacrimal duct recanalization (TELDR) in patients with primary acquired nasolacrimal duct obstruction (PANDO) as an alternative to open biopsy, the standard method used in collecting specimen. Methods: This is a noncomparative, interventional case series with histopathologic correlation. Patients diagnosed with complete PANDO who underwent TELDR with balloon dacryoplasty and silicone intubation with CM at University of Santo Tomas Hospital from October 2014 to January 2017 were included. Results: Twenty (20) tissue specimens from the lacrimal sac and nasolacrimal duct were obtained from 18 patients. There were 16 females and 2 males included in the study. Mean age was 57.5 years. All specimens revealed few clusters of benign epithelial cells with few degenerated mononuclear cells and lymphocytes, and singly scattered lymphocytes that are set in fibrinous background. Tissue cytology studies were negative for malignant cells. Conclusion CM is a minimally invasive procedure that offers an alternative to open biopsy technique that can be done routinely during TELDR.
Dacryocystorhinostomy ; Lacrimal Apparatus Diseases

PURPOSE: The correspondence between the canaliculus irrigation test, dacryocystography, and Jones test in patients with epiphora was investigated. METHODS: The study included 494 eyes of 359 patients who complained of epiphora and underwent both canaliculus irrigation test and dacryocystography from May 2001 to March 2006. Sixty-eight eyes from 34 patients diagnosed with functional lacrimal duct obstruction took Jones tests. Factors such as age, sex, duration of epiphora, and site of obstruction were analyzed in terms of correspondence of the tests. RESULTS: Between the canaliculus irrigation test and dacryocystography, correspondent rate was 55%. Correspondence had no relation to patient age, sex, duration of epiphora, or site of obstruction. Between Jones test and dacryocystography, the correspondent rate was 47%. Factors affecting the correspondences were not significantly found. CONCLUSIONS: A canaliculus irrigation test can give useful information with high correspondence rate of dacryocystography in the case of 'not pass' or 'pass without regurgitation'. Therefore dacryocystography should be utilized in "pass with regurgitation" cases by canaliculus irrigation test.
Humans ; Lacrimal Apparatus Diseases* ; Lacrimal Duct Obstruction

PURPOSE: To evaluate the internal ostium and lacrimal sac change after external dacryocystorhinostomy (DCR) using digital subtraction dacryocystography (DCG). METHODS: Between May 2003 and July 2004, digital subtraction DCG was performed to assess the ostium and lacrimal sac 6 months after external DCR in 48 patients (n=50 eyes). RESULTS: The lacrimal sac had reformed in 45 (90%) eyes. Mean ostium size was 2.4 mm (0.5~6.1 mm) and these were located at the inferior part of the reformed sac in 39 eyes (78%). Patients with a fistula-type internal ostium, of which the lacrimal sac had not reformed, often complained of epiphora (p=0.005). CONCLUSIONS: Digital subtraction DCG showed successful anatomic changes in the distal lacrimal pathway and confirmed that the internal ostium contracts into a relatively small ostium after DCR. A fistula-type internal ostium may explain the pathophysiology of functional failure after successful DCR.
Dacryocystorhinostomy* ; Humans ; Lacrimal Apparatus Diseases

PURPOSE: The purpose of this study was to compare contrast dacryocystography with lacrimal dacryo-scintigraphy in correlation with epiphora, superiority in localization of the site of obstruction and discomfort of partient during procedures. MATERIAL AND METHODS: Lacrimal dacryoscintigraphy and contrast dacryocystography were performed in 200 lacrimal drainage systems in 100 patients who were referred to our hospital with epiphora since January, 1993. RESULTS: Lacrimal dacryoscintigraphy showed 88% in correlation with epiphora, 90% in positive predictive value and 74% in negative predictive value. Contrast dacryocystography showed 72% in correlation with epiphora, 97% in positive predictive value and 60% in negative predictive value. Contrast dacryocystography was superior to lacrimal dacryoscintigraphy in localization of the site of the obstruction because of limitation of resolution of 6mm pin hole collimator. But discomfort of patient was variable and severe on contrast dacryocystography. CONCLUSION: When obstruction is suspected, we recommend the lacrimal dacryoscintigraphy as initial radio-graphic study. If adequate information is not available and confirmation is necessary, contrast dacryo-cystography should be done in next step. Inspite of patient symptom, if finding of contrast dacryocystography is normal, lacrimal dacryoscintigraphy should be performed to exclude functional obstruction.
Drainage ; Humans ; Lacrimal Apparatus Diseases*

PURPOSE: The purpose of this study was to compare contrast dacryocystography with lacrimal dacryo-scintigraphy in correlation with epiphora, superiority in localization of the site of obstruction and discomfort of partient during procedures. MATERIAL AND METHODS: Lacrimal dacryoscintigraphy and contrast dacryocystography were performed in 200 lacrimal drainage systems in 100 patients who were referred to our hospital with epiphora since January, 1993. RESULTS: Lacrimal dacryoscintigraphy showed 88% in correlation with epiphora, 90% in positive predictive value and 74% in negative predictive value. Contrast dacryocystography showed 72% in correlation with epiphora, 97% in positive predictive value and 60% in negative predictive value. Contrast dacryocystography was superior to lacrimal dacryoscintigraphy in localization of the site of the obstruction because of limitation of resolution of 6mm pin hole collimator. But discomfort of patient was variable and severe on contrast dacryocystography. CONCLUSION: When obstruction is suspected, we recommend the lacrimal dacryoscintigraphy as initial radio-graphic study. If adequate information is not available and confirmation is necessary, contrast dacryo-cystography should be done in next step. Inspite of patient symptom, if finding of contrast dacryocystography is normal, lacrimal dacryoscintigraphy should be performed to exclude functional obstruction.
Drainage ; Humans ; Lacrimal Apparatus Diseases*

No abstract available.
Eye Diseases, Hereditary ; Humans ; Lacrimal Apparatus Diseases

No abstract available.
Eye Diseases, Hereditary ; Humans ; Lacrimal Apparatus Diseases

Epiphora is one of the most common problems in ophthalmological practice, and is caused by dysfunction of the lacrimal pathway. The lacrimal drainage system is a continuous anatomical structure consisting of the lacrimal punctum, inferior and superior canaliculi, common canaliculus, lacrimal sac, and nasolacrimal duct. Lacrimal disease can be medically treated in case of acute inflammation or partial obstruction at the beginning of treatment, but surgical treatment is necessary in most cases. This paper discusses the etiology, clinical features, diagnosis, and surgical treatment of various lacrimal diseases through a selective review of the relevant literature. Advances in lacrimal duct surgery can now be performed in such a way that the structural integrity and normal physiological function of the entire efferent lacrimal pathway is preserved.
Dacryocystorhinostomy ; Diagnosis ; Drainage* ; Inflammation ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases ; Lacrimal Duct Obstruction ; Nasolacrimal Duct

PURPOSE: To investigate the different types of anatomical connection between the lacrimal sac and the canaliculi using digital subtraction dacryocystography (DCG) in Koreans. METHODS: The authors of the present study performed digital subtraction DCG in Korean patients who presented with epiphora from January 2010 until December 2010. The 248 patients (496 eyes) who achieved a satisfactory DCG image were classified as follows: 1) type I: visible common canaliculus (CC), 2) type II: no visible CC and the canaliculi entering the sac at the point where they meet on the sac wall (common opening), 3) type III: no visible CC and common opening, and each canaliculus entering the sac from different points. RESULTS: Out of a total of 496 eyes, CC was observed in 449 eyes (type I: 90.5%). In 41 eyes (8.3%), the CC was absent (type II), but the upper and lower canaliculi joined at the wall of the lacrimal sac. In 6 eyes (1.2%), the upper and lower canaliculi entered the sac separately (type III). Eighteen patients (7.3%) showed different types of lacrimal drainage system between the 2 eyes. CONCLUSIONS: The CC may not exist in all patients, and the type of anatomical connection between the lacrimal sac and the canaliculi may be different between the eyes in the same individuals. Although such patients comprise a minority, anatomical knowledge of the lacrimal drainage system could be helpful to assess and manage patients with lacrimal drainage disorder.
Drainage ; Eye ; Humans ; Lacrimal Apparatus Diseases

PURPOSE: The degree of laxity of the medial and lateral canthal tendon in Korean subjects with and without involutional entropion and epiphora was evaluated in the present study. METHODS: The present study included 180 normal subjects (360 eyes), 12 patients (15 eyes) with involutional entropion, and 41 patients (58 eyes) with epiphora. The degree of laxity of the medial and lateral canthal tendon, which grades the position of the inferior punctum, was measured using the lateral and medial distraction test. RESULTS: The mean degree of medial and lateral canthal tendon laxity was 1.83/1.08 in normal subjects. A statistical difference was not observed between sexes, and the mean degree of laxity tended to be higher in older patients. The mean degree of laxity was 2.78/2.18 and 2.28/1.22 in the involutional entropion group and the epiphora group, respectively. The involutional entropion group and the epiphora group underwent endoscopic endonasal dacryocystitis (D), medial spindle procedure (M), and endoscopic endonasal dacryocystitis with the medial spindle procedure and/or the tarsal strip procedure (T). The mean degree of laxity was 1.84/1.04 in group D, 3.00/1.20 in group M, 2.33/2.00 in group D + T, 3.20/1.40 in group D + M and 3.50/2.00 in group D + T + M before surgery. CONCLUSIONS: The results from the present study may aid in the selection of a basic treatment plan for Korean patients with involutional entropion or epiphora.
Dacryocystitis ; Entropion ; Humans ; Lacrimal Apparatus Diseases ; Tendons