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Outcome of external dacryocystorhinostomy combined with membranectomy of a distal canalicular obstruction.
Am J Ophthalmol. 2005 Jun; 139(6):1051-5.AJ

Abstract

PURPOSE

To investigate the accuracy of the preoperative evaluation in identifying a membranous obstruction of the distal canaliculus and the success rate of an external dacryocystorhinostomy (DCR) when membranectomy of the canalicular obstruction is also performed.

DESIGN

Retrospective, interventional case series.

METHODS

The surgical records of the lacrimal cases operated at Moorfields Eye Hospital between January 1997 and December 1999 were reviewed. All the patients with evidence of a membranous block of the canalicular opening into the sac identified and excised during the course of a standard DCR procedure with silastic intubation and a minimum follow-up period of 12 months were selected for this study. The records were analyzed for preoperative evaluation with syringing and probing, surgical details, outcome, and complications.

RESULTS

In 59 (85%) cases a functional anastomosis was established after tube removal. Additionally, 5 cases (7%) had patent system but required later ectropion repair and considered successful. Only 4 (6%) patients needed further lacrimal surgery, and one was referred to the ENT department for nasal polyps. The silastic tube was removed at a mean period of 6 weeks (SD = 4; range, 2-24 weeks), and the mean follow-up period was 13 months (SD = 3; range, 12-29 months). The preoperative evaluation failed to identify the membranous obstruction in 30 (43%) cases, which were correctly diagnosed intraoperatively.

CONCLUSIONS

In our series the anatomic success rate of 92% after DCR with membranectomy is comparable to the outcome of the DCR procedure. The distal canalicular membranous obstruction is an anatomic factor that may lead to surgical failure if not identified and excised.

Authors+Show Affiliations

Ophthalmology Department, Aristotle University, Pavlou Mela 16, 546-22 Thessaloniki, Greece. kosbob@otenet.grNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15953435

Citation

Boboridis, Kostas G., et al. "Outcome of External Dacryocystorhinostomy Combined With Membranectomy of a Distal Canalicular Obstruction." American Journal of Ophthalmology, vol. 139, no. 6, 2005, pp. 1051-5.
Boboridis KG, Bunce C, Rose GE. Outcome of external dacryocystorhinostomy combined with membranectomy of a distal canalicular obstruction. Am J Ophthalmol. 2005;139(6):1051-5.
Boboridis, K. G., Bunce, C., & Rose, G. E. (2005). Outcome of external dacryocystorhinostomy combined with membranectomy of a distal canalicular obstruction. American Journal of Ophthalmology, 139(6), 1051-5.
Boboridis KG, Bunce C, Rose GE. Outcome of External Dacryocystorhinostomy Combined With Membranectomy of a Distal Canalicular Obstruction. Am J Ophthalmol. 2005;139(6):1051-5. PubMed PMID: 15953435.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome of external dacryocystorhinostomy combined with membranectomy of a distal canalicular obstruction. AU - Boboridis,Kostas G, AU - Bunce,Catey, AU - Rose,Geoffrey E, PY - 2004/09/05/received PY - 2005/01/05/accepted PY - 2005/6/15/pubmed PY - 2005/7/29/medline PY - 2005/6/15/entrez SP - 1051 EP - 5 JF - American journal of ophthalmology JO - Am J Ophthalmol VL - 139 IS - 6 N2 - PURPOSE: To investigate the accuracy of the preoperative evaluation in identifying a membranous obstruction of the distal canaliculus and the success rate of an external dacryocystorhinostomy (DCR) when membranectomy of the canalicular obstruction is also performed. DESIGN: Retrospective, interventional case series. METHODS: The surgical records of the lacrimal cases operated at Moorfields Eye Hospital between January 1997 and December 1999 were reviewed. All the patients with evidence of a membranous block of the canalicular opening into the sac identified and excised during the course of a standard DCR procedure with silastic intubation and a minimum follow-up period of 12 months were selected for this study. The records were analyzed for preoperative evaluation with syringing and probing, surgical details, outcome, and complications. RESULTS: In 59 (85%) cases a functional anastomosis was established after tube removal. Additionally, 5 cases (7%) had patent system but required later ectropion repair and considered successful. Only 4 (6%) patients needed further lacrimal surgery, and one was referred to the ENT department for nasal polyps. The silastic tube was removed at a mean period of 6 weeks (SD = 4; range, 2-24 weeks), and the mean follow-up period was 13 months (SD = 3; range, 12-29 months). The preoperative evaluation failed to identify the membranous obstruction in 30 (43%) cases, which were correctly diagnosed intraoperatively. CONCLUSIONS: In our series the anatomic success rate of 92% after DCR with membranectomy is comparable to the outcome of the DCR procedure. The distal canalicular membranous obstruction is an anatomic factor that may lead to surgical failure if not identified and excised. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/15953435/Outcome_of_external_dacryocystorhinostomy_combined_with_membranectomy_of_a_distal_canalicular_obstruction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(05)00014-0 DB - PRIME DP - Unbound Medicine ER -