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Primary treatment of acute dacryocystitis by endoscopic dacryocystorhinostomy with silicone intubation guided by a soft probe.
Ophthalmology. 2009 Jan; 116(1):116-22.O

Abstract

PURPOSE

To investigate the suitability of cold steel endonasal endoscopic dacryocystorhinostomy (EES-DCR) with circular bicanalicular intubation with silicone tubes (CBIST) guided by a soft probe for the primary treatment of acute purulent dacryocystitis (APD).

DESIGN

Prospective, randomized, interventional case series.

PARTICIPANTS

Seventy-two patients (59 females, 13 males) with a median presenting age of 55+/-12 years (range, 28-71 years).

METHODS

Eighty-four patients with unilateral APD were equally and randomly divided into 2 groups. Cold steel EES-DCR was performed after the lacrimal abscess formation, and external dacryocystorhinostomy (E-DCR) was performed 1 to 2 weeks after resolution of the acute inflammation. In both groups, CBIST guided by a soft probe was performed and the silicone tubes were kept in the lacrimal passages for 3 months. Postoperative follow-up ranged from 12 to 24 months. Outcomes were compared between both groups, considering resolution time for external acute inflammation, success rate of free lacrimal passage reconstruction, and lack of complications as indicators of treatment suitability.

MAIN OUTCOME MEASURES

Time for resolution of the external acute inflammation, success rate of free lacrimal passage reconstruction, and complications.

RESULTS

In this study, complete postoperative data were acquired from 40 patients in the EES-DCR group and from 32 patients in the E-DCR group, and the outcomes were compared. Acute inflammation resolved more quickly in the EES-DCR group than in the E-DCR group (P<0.05). Ostium patency at 12 months after silicone tube removal was achieved in significantly more patients in the EES-DCR group (36/40 [90%]) than in the E-DCR group (21/32 [65.7%]; P<0.01). In the EES-DCR group, lacrimal passage reconstruction failed because of intranasal ostial closure in 3 patients and because of common canaliculus obstruction in 1 patient. In the E-DCR group, lacrimal passage reconstruction failed because of intranasal ostial closure in 3 patients, lacrimal sac fibrosis, granulation, or both in 6 patients, and common canaliculus obstruction in 2 patients. Other than the slight laceration of the inferior puncta, no significant complications arose from the treatments.

CONCLUSIONS

Cold steel EES-DCR with CBIST guided by a soft probe is a promising alternative for the primary treatment of APD with abscess formation.

FINANCIAL DISCLOSURE(S)

The authors have no proprietary or commercial interest in any materials discussed in this article.

Authors+Show Affiliations

Eye Hospital of Wenzhou Medical College, Wenzhou, Peoples' Republic of China. wuwencan118@163.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19118702

Citation

Wu, Wencan, et al. "Primary Treatment of Acute Dacryocystitis By Endoscopic Dacryocystorhinostomy With Silicone Intubation Guided By a Soft Probe." Ophthalmology, vol. 116, no. 1, 2009, pp. 116-22.
Wu W, Yan W, MacCallum JK, et al. Primary treatment of acute dacryocystitis by endoscopic dacryocystorhinostomy with silicone intubation guided by a soft probe. Ophthalmology. 2009;116(1):116-22.
Wu, W., Yan, W., MacCallum, J. K., Tu, Y., Jiang, A. C., Yang, Y., Xiao, T., Li, J., Wang, Q., & Qu, J. (2009). Primary treatment of acute dacryocystitis by endoscopic dacryocystorhinostomy with silicone intubation guided by a soft probe. Ophthalmology, 116(1), 116-22. https://doi.org/10.1016/j.ophtha.2008.09.041
Wu W, et al. Primary Treatment of Acute Dacryocystitis By Endoscopic Dacryocystorhinostomy With Silicone Intubation Guided By a Soft Probe. Ophthalmology. 2009;116(1):116-22. PubMed PMID: 19118702.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary treatment of acute dacryocystitis by endoscopic dacryocystorhinostomy with silicone intubation guided by a soft probe. AU - Wu,Wencan, AU - Yan,Wentao, AU - MacCallum,Julia K, AU - Tu,Yunhai, AU - Jiang,Alice C, AU - Yang,Yuan, AU - Xiao,Tianlin, AU - Li,Jin, AU - Wang,Qinmei, AU - Qu,Jia, PY - 2008/02/05/received PY - 2008/09/21/revised PY - 2008/09/24/accepted PY - 2009/1/3/entrez PY - 2009/1/3/pubmed PY - 2009/1/16/medline SP - 116 EP - 22 JF - Ophthalmology JO - Ophthalmology VL - 116 IS - 1 N2 - PURPOSE: To investigate the suitability of cold steel endonasal endoscopic dacryocystorhinostomy (EES-DCR) with circular bicanalicular intubation with silicone tubes (CBIST) guided by a soft probe for the primary treatment of acute purulent dacryocystitis (APD). DESIGN: Prospective, randomized, interventional case series. PARTICIPANTS: Seventy-two patients (59 females, 13 males) with a median presenting age of 55+/-12 years (range, 28-71 years). METHODS: Eighty-four patients with unilateral APD were equally and randomly divided into 2 groups. Cold steel EES-DCR was performed after the lacrimal abscess formation, and external dacryocystorhinostomy (E-DCR) was performed 1 to 2 weeks after resolution of the acute inflammation. In both groups, CBIST guided by a soft probe was performed and the silicone tubes were kept in the lacrimal passages for 3 months. Postoperative follow-up ranged from 12 to 24 months. Outcomes were compared between both groups, considering resolution time for external acute inflammation, success rate of free lacrimal passage reconstruction, and lack of complications as indicators of treatment suitability. MAIN OUTCOME MEASURES: Time for resolution of the external acute inflammation, success rate of free lacrimal passage reconstruction, and complications. RESULTS: In this study, complete postoperative data were acquired from 40 patients in the EES-DCR group and from 32 patients in the E-DCR group, and the outcomes were compared. Acute inflammation resolved more quickly in the EES-DCR group than in the E-DCR group (P<0.05). Ostium patency at 12 months after silicone tube removal was achieved in significantly more patients in the EES-DCR group (36/40 [90%]) than in the E-DCR group (21/32 [65.7%]; P<0.01). In the EES-DCR group, lacrimal passage reconstruction failed because of intranasal ostial closure in 3 patients and because of common canaliculus obstruction in 1 patient. In the E-DCR group, lacrimal passage reconstruction failed because of intranasal ostial closure in 3 patients, lacrimal sac fibrosis, granulation, or both in 6 patients, and common canaliculus obstruction in 2 patients. Other than the slight laceration of the inferior puncta, no significant complications arose from the treatments. CONCLUSIONS: Cold steel EES-DCR with CBIST guided by a soft probe is a promising alternative for the primary treatment of APD with abscess formation. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/19118702/Primary_treatment_of_acute_dacryocystitis_by_endoscopic_dacryocystorhinostomy_with_silicone_intubation_guided_by_a_soft_probe_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(08)01007-5 DB - PRIME DP - Unbound Medicine ER -