A simple and evolutional approach proven to recanalise the nasolacrimal duct obstruction

Br J Ophthalmol. 2009 Nov;93(11):1438-43. doi: 10.1136/bjo.2008.149393. Epub 2009 May 4.

Abstract

Aim: To evaluate a new approach of recanalisation of nasolacrimal duct obstruction (RC-NLDO) in the treatment of the nasolacrimal duct obstruction (NLDO) and chronic dacryocystitis.

Methods: 583 patients with 641 eyes suffering from NLDO and chronic dacryocystitis were enrolled in this study. The RC-NLDO was performed in 506 eyes, with 135 eyes undergoing external dacryocystorhinostomy (EX-DCR) as controls. Patient follow-up for 54 months was evaluated by symptoms, dye disappearance test, lacrimal irrigation and digital subtraction dacryocystogram. The RC-NLDO was also performed in 12 rhesus monkeys for histopathological examination.

Results: The clinical success rates were 93.1% in 506 cases of RC-NLDO and 91.11% in 135 cases of EX-DCR. The success rates for second surgery were achieved in 85.19% on RC-NLDO and 40.0% on EX-DCR. No major intra- or postoperative complications were observed in the RC-NLDO group. The mean operative duration was 12.5 min for RC-NLDO and 40.3 min for EX-DCR (p<0.001). A pathological study in rhesus monkeys demonstrated that the RC-NLDO wounded epithelium in nasolacrimal duct healed completely within 1 month without granulation tissue formation.

Conclusion: The findings demonstrate that the RC-NLDO is a simple and effective approach proven to recanalise the obstructed nasolacrimal duct with a comparable success rate to EX-DCR.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Catheterization / instrumentation
  • Dacryocystorhinostomy* / instrumentation
  • Dacryocystorhinostomy* / methods*
  • Equipment Design
  • Female
  • Humans
  • Lacrimal Duct Obstruction / pathology
  • Macaca mulatta
  • Male
  • Middle Aged
  • Nasolacrimal Duct / pathology
  • Nasolacrimal Duct / surgery*
  • Postoperative Care / methods
  • Wound Healing