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Modified conjunctivodacryocystorhinostomy for upper lacrimal system obstruction.
Arch Facial Plast Surg. 2007 Mar-Apr; 9(2):96-100.AF

Abstract

OBJECTIVE

To describe a modified technique for conjunctivodacryocystorhinostomy (CDCR) and to compare this technique with the standard transcaruncular placement of the glass tube.

METHODS

Patients with upper lacrimal system obstruction underwent CDCR at the Jules Stein Eye Institute during a 3-year period. Thirteen patients underwent modified CDCR leaving the caruncle intact, while 7 patients underwent Jones glass tubes placement through a caruncular incision (conventional CDCR). Data regarding ocular and tearing history were recorded and analyzed. Success rates, defined as complete improvement in tearing, were compared between patients who underwent standard CDCR and those who underwent modified CDCR. Main outcome measures included symptom relief, patients' tolerance of the Jones tube, and surgical complications.

RESULTS

Nineteen patients (12 men and 7 women; mean age, 66 years) underwent 20 CDCR surgical procedures with Jones tube placement. Previous lacrimal history included malignancy of the ocular adnexa, trauma, chemotherapy, and previous failed dacryocystorhinostomy. Success was found in 13 surgical cases (65%) and partial improvement was found in 4, giving a qualified success rate of 85%. Patients who underwent modified CDCR were more likely to undergo a successful surgery compared with patients who underwent conventional CDCR, with 11 (85%) of 13 cases achieving complete improvement vs 2 (29%) of 7 cases in the conventional CDCR group (P = .03, Fisher exact test). Complications included 1 case of migration and loss of the Jones tube.

CONCLUSION

Modified CDCR results in partial or complete resolution of tearing in nearly 92% of cases, allowing for an improved outcome both functionally and cosmetically compared with conventional CDCR.

Authors+Show Affiliations

Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. rschwarcz@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17372062

Citation

Schwarcz, Robert M., et al. "Modified Conjunctivodacryocystorhinostomy for Upper Lacrimal System Obstruction." Archives of Facial Plastic Surgery, vol. 9, no. 2, 2007, pp. 96-100.
Schwarcz RM, Lee S, Goldberg RA, et al. Modified conjunctivodacryocystorhinostomy for upper lacrimal system obstruction. Arch Facial Plast Surg. 2007;9(2):96-100.
Schwarcz, R. M., Lee, S., Goldberg, R. A., & Simon, G. J. (2007). Modified conjunctivodacryocystorhinostomy for upper lacrimal system obstruction. Archives of Facial Plastic Surgery, 9(2), 96-100.
Schwarcz RM, et al. Modified Conjunctivodacryocystorhinostomy for Upper Lacrimal System Obstruction. Arch Facial Plast Surg. 2007 Mar-Apr;9(2):96-100. PubMed PMID: 17372062.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modified conjunctivodacryocystorhinostomy for upper lacrimal system obstruction. AU - Schwarcz,Robert M, AU - Lee,Seongmu, AU - Goldberg,Robert A, AU - Simon,Guy J Ben, PY - 2007/3/21/pubmed PY - 2007/5/9/medline PY - 2007/3/21/entrez SP - 96 EP - 100 JF - Archives of facial plastic surgery JO - Arch Facial Plast Surg VL - 9 IS - 2 N2 - OBJECTIVE: To describe a modified technique for conjunctivodacryocystorhinostomy (CDCR) and to compare this technique with the standard transcaruncular placement of the glass tube. METHODS: Patients with upper lacrimal system obstruction underwent CDCR at the Jules Stein Eye Institute during a 3-year period. Thirteen patients underwent modified CDCR leaving the caruncle intact, while 7 patients underwent Jones glass tubes placement through a caruncular incision (conventional CDCR). Data regarding ocular and tearing history were recorded and analyzed. Success rates, defined as complete improvement in tearing, were compared between patients who underwent standard CDCR and those who underwent modified CDCR. Main outcome measures included symptom relief, patients' tolerance of the Jones tube, and surgical complications. RESULTS: Nineteen patients (12 men and 7 women; mean age, 66 years) underwent 20 CDCR surgical procedures with Jones tube placement. Previous lacrimal history included malignancy of the ocular adnexa, trauma, chemotherapy, and previous failed dacryocystorhinostomy. Success was found in 13 surgical cases (65%) and partial improvement was found in 4, giving a qualified success rate of 85%. Patients who underwent modified CDCR were more likely to undergo a successful surgery compared with patients who underwent conventional CDCR, with 11 (85%) of 13 cases achieving complete improvement vs 2 (29%) of 7 cases in the conventional CDCR group (P = .03, Fisher exact test). Complications included 1 case of migration and loss of the Jones tube. CONCLUSION: Modified CDCR results in partial or complete resolution of tearing in nearly 92% of cases, allowing for an improved outcome both functionally and cosmetically compared with conventional CDCR. SN - 1521-2491 UR - https://www.unboundmedicine.com/medline/citation/17372062/Modified_conjunctivodacryocystorhinostomy_for_upper_lacrimal_system_obstruction_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=17372062.ui DB - PRIME DP - Unbound Medicine ER -