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 report a case of congenital lacrimal outflow dysgenesis with supernumerary lacrimal puncta. CASE SUMMARY: A 45-years-old woman presented with chronic bilateral epiphora with no specific medical history. Slit-lamp examination revealed bilateral upper and lower double puncta. The accessory puncta were situated along the lid margin, medial to the normal one and had a typical slit configuration. Additionally, there was a lower canalicular system block that appeared unresponsive to simple probing. Bilateral endoscopic conjunctivodacryocystorhinostomy with Jones tube was performed. Chronic bilateral epiphora was relieved after bilateral endoscopic conjunctivodacryocystorhinostomy with Jones tube. CONCLUSIONS: A case of congenital lacrimal outflow dysgenesis with supernumerary lacrimal puncta was observed, which has not been previously reported in Korea. Surgical repair of the congenital lacrimal outflow dysgenesis with supernumerary lacrimal puncta should be considered to achieve a functional recovery of the lacrimal drainage system.
Drainage ; Female ; Humans ; Korea ; Lacrimal Apparatus Diseases

PURPOSE: To investigate the surgical outcome of silicone tube intubation after simple probing performed in obstruction of distal part of canaliculus or common canaliculus. METHODS: Silicone tube intubation was done in 24 patients with obstruction of distal part of canaliculus or common canaliculus, whose obstruction was readily opened by simple probing under mild pushing pressure and who had successful lacrimal irrigation after probing. Silicone tube was removed at about 6 months after operation and the epiphora improvement, dye disappearance test, and lacrimal irrigation test were evaluated at 2 month after the intubation and 2 months after the tube removal. RESULTS: The average of probing to perforate the obstructed canaliculus were 2.1. At 1 month after the intubation, epiphora was improved in 19 patients (79.2%), and 18 patients (75.0%) showed a grade 2+ or lower in dye disappearance test, and lacrimal irrigation was successful in 21 patients (87.5%). 2 months after the tube removal, epiphora was improved in 18 patients (75.0%), and 18 patients (75.0%) showed a grade 2+ or lower in dye disappearance test, and lacrimal irrigation was successful in 20 patients (83.3%). CONCLUSIONS: When the obstruction of distal part of canaliculus or common canaliculus is thin membranous nature, good surgical outcome can be expected by silicone tube intubation after simple probing using mild pushing pressure without other special procedure.
Humans ; Intubation* ; Lacrimal Apparatus Diseases ; Silicones*