Nasolacrimal duct reconstitution with radiofrequency: case report

Purpose To describe a minimal invasive technique for nasolacrimal duct reconstitution with radiofrequency in a case of lacrimal flow restriction. Methods Case report of a 23 years-old female, with previous history of tearing, swelling, redness and pain over the innermost aspect of the lower eyelid of her right eye (RE). The symptoms started four years ago and sometimes relapses and discharge. The patient denies any other comorbilities, systemic or local complaints or any medication. External examination RE: Milder test +++, BUT inferior to 3’’. LE: Milder test +, BUT inferior to 3’’. Both eyes present inferior punctate keratopathy. It was diagnosed low nasolacrimal obstruction in RE, confirmed with dacriocistography. Treatment option was nasolacrimal duct reconstitution with radiofrequency under sedation and local anesthesia. Results The patient was followed for at least one year. She was evaluated for the presence of secretion, epiphora, reflux at compression of the lacrimal sac, placement of silicone tube and Milder test. At postoperative visits, the patient presented positive irrigation with clearance of lacrimal duct. Conclusions Reconstitution with radio frequency seems to be a solution to be considered. The presented technique was effective in the treatment of nasolacrimal duct obstruction with a good safety profile, being less invasive when compared with the classic DCR. Prospective, comparative, multicentric studies and larger follow up are still needed.