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Retrograde intubation dacryocystorhinostomy for proximal and midcanalicular obstruction.
Ophthalmology. 1999 Dec; 106(12):2325-8; discussion 2328-9.O

Abstract

OBJECTIVE

Retrograde intubation of canaliculi during dacryocystorhinostomy can restore canalicular patency in cases otherwise managed with bypass tubes. The surgical technique and success for this procedure are discussed.

DESIGN

A retrospective, noncomparative case series with clinic or telephone interview for long-term follow-up of patients' symptoms.

PARTICIPANTS

One hundred two patients who had undergone this particular lacrimal drainage surgery at Moorfields Eye Hospital between 1992 and 1997.

INTERVENTION

All patients underwent a dacryocystorhinostomy and retrograde canaliculostomy while under general anesthetic.

MAIN OUTCOME MEASURES

Relief or reduction of epiphora and discharge.

RESULTS

One hundred twenty-three lacrimal systems of 102 patients were included. There were 53 females and 49 males, with ages at surgery ranging from 6 to 83 years (mean, 49 years). The etiology was idiopathic (30%), herpetic canaliculitis (24%), punctal agenesis (18%), and trauma (11%); less-common causes included dacryocystitis, Stevens-Johnson syndrome, eczema, and prior radiation therapy. Both upper and lower canalicular systems were involved in the majority (73%) of patients, and in 13 (11%) systems a dacryocystorhinostomy had previously been performed. The silicone tube was placed for a mean of 2 months (range, 1 week-9 months), and the mean postoperative follow-up was 8 months (range, 2-24 months). Epiphora subjectively improved in 90 (73%) of 123 systems, of which 27 (22%) of 123 were asymptomatic. In 33 systems (27%) in which epiphora persisted, 14 (11%) have undergone closed placement of a Jones canalicular bypass tube with control of symptoms.

CONCLUSIONS

Retrograde canaliculostomy and intubation can spare a significant number of patients the long-term inconvenience of Jones tubes. Failure of this technique does not, however, compromise or complicate the future placement of a bypass tube.

Authors+Show Affiliations

Moorfields Eye Hospital, London, England.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10599666

Citation

Wearne, M J., et al. "Retrograde Intubation Dacryocystorhinostomy for Proximal and Midcanalicular Obstruction." Ophthalmology, vol. 106, no. 12, 1999, pp. 2325-8; discussion 2328-9.
Wearne MJ, Beigi B, Davis G, et al. Retrograde intubation dacryocystorhinostomy for proximal and midcanalicular obstruction. Ophthalmology. 1999;106(12):2325-8; discussion 2328-9.
Wearne, M. J., Beigi, B., Davis, G., & Rose, G. E. (1999). Retrograde intubation dacryocystorhinostomy for proximal and midcanalicular obstruction. Ophthalmology, 106(12), 2325-8; discussion 2328-9.
Wearne MJ, et al. Retrograde Intubation Dacryocystorhinostomy for Proximal and Midcanalicular Obstruction. Ophthalmology. 1999;106(12):2325-8; discussion 2328-9. PubMed PMID: 10599666.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrograde intubation dacryocystorhinostomy for proximal and midcanalicular obstruction. AU - Wearne,M J, AU - Beigi,B, AU - Davis,G, AU - Rose,G E, PY - 1999/12/22/pubmed PY - 1999/12/22/medline PY - 1999/12/22/entrez SP - 2325-8; discussion 2328-9 JF - Ophthalmology JO - Ophthalmology VL - 106 IS - 12 N2 - OBJECTIVE: Retrograde intubation of canaliculi during dacryocystorhinostomy can restore canalicular patency in cases otherwise managed with bypass tubes. The surgical technique and success for this procedure are discussed. DESIGN: A retrospective, noncomparative case series with clinic or telephone interview for long-term follow-up of patients' symptoms. PARTICIPANTS: One hundred two patients who had undergone this particular lacrimal drainage surgery at Moorfields Eye Hospital between 1992 and 1997. INTERVENTION: All patients underwent a dacryocystorhinostomy and retrograde canaliculostomy while under general anesthetic. MAIN OUTCOME MEASURES: Relief or reduction of epiphora and discharge. RESULTS: One hundred twenty-three lacrimal systems of 102 patients were included. There were 53 females and 49 males, with ages at surgery ranging from 6 to 83 years (mean, 49 years). The etiology was idiopathic (30%), herpetic canaliculitis (24%), punctal agenesis (18%), and trauma (11%); less-common causes included dacryocystitis, Stevens-Johnson syndrome, eczema, and prior radiation therapy. Both upper and lower canalicular systems were involved in the majority (73%) of patients, and in 13 (11%) systems a dacryocystorhinostomy had previously been performed. The silicone tube was placed for a mean of 2 months (range, 1 week-9 months), and the mean postoperative follow-up was 8 months (range, 2-24 months). Epiphora subjectively improved in 90 (73%) of 123 systems, of which 27 (22%) of 123 were asymptomatic. In 33 systems (27%) in which epiphora persisted, 14 (11%) have undergone closed placement of a Jones canalicular bypass tube with control of symptoms. CONCLUSIONS: Retrograde canaliculostomy and intubation can spare a significant number of patients the long-term inconvenience of Jones tubes. Failure of this technique does not, however, compromise or complicate the future placement of a bypass tube. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/10599666/Retrograde_intubation_dacryocystorhinostomy_for_proximal_and_midcanalicular_obstruction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(99)90535-3 DB - PRIME DP - Unbound Medicine ER -