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Type: Journal article
Title: A prospective outcome study of membranous and solid distal common canalicular obstructions
Author: Shams, P.
Pirbhai, A.
Selva, D.
Citation: Eye, 2016; 30(4):621-626
Publisher: Nature Publishing Group
Issue Date: 2016
ISSN: 0950-222X
Statement of
P. N. Shams, A. Pirbhai and D. Selva
Abstract: To prospectively evaluate the surgical outcomes of membranous and solid distal common canalicular obstructions (CCOs) following endoscopic dacryocystorhinostomy (EnDCR) and lacrimal intubation combined with either membranotomy or trephination.This was a prospective, non-randomized, consecutive interventional case series. Inclusion criteria included patients undergoing EnDCR with evidence of a membranous block or more solid obstruction of the distal common canaliculus, treated with membranotomy or canalicular trephination. Complete CCO was confirmed pre-operatively using dacryocystography and dacryoscintigraphy. All patients received bicanalicular intubation for 3 months with a minimum follow-up of 12 months. Functional and anatomical success was assessed at 4 weeks, 3 months, and 12 months following surgery. Functional success was defined as subjective improvement of epiphora and anatomical success as the presence of a patent ostium and a positive dye test on nasal endoscopy.Twenty-nine patients were included in the study with a mean age of 58 years. Twenty-one patients (72%) received a membranotomy and eight (28%) required trephination. At 12 months, the functional and anatomical success rate in the membranotomy group was 90% (19/21) and 100% (21/21), respectively, and in trephination group the functional and anatomical success rate was 63% (5/8). There were no intra-operative or lacrimal stent-related complications.Identifying and excising distal CCOs in association with EnDCR and lacrimal intubation is associated with a high degree of functional (83%) and anatomical (90%) success. The success of membranous obstructions appear be superior to outcomes for solid obstructions of the distal common canaliculus that require trephination.
Keywords: Membranous obstructions
Rights: © 2016 Macmillan Publishers Limited All rights reserved
RMID: 0030043811
DOI: 10.1038/eye.2016.11
Appears in Collections:Opthalmology & Visual Sciences publications

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