Dacryoendoscopy: feasibility and value as diagnostic tool

Purpose: To access the feasibility and value of endoscopy of the lacrimal duct as a diagnostic method in setnoses of the lacrimal drainage system. Methods: In this prospective study 50 patients with prolonged complaints of epiphora or history of recurrent dacryocystitis were included. All patients underwent clinical examinations including syringation, digital dacryocystography and dacryoendoscopy before a decision for appropriate surgical treatment was made. Findings of clinical examinations, dacryocystography and dacryoendoskopy were compared in regard of feasibility, localization of the obstruction, particular informations provided and correlation between the three methods. Results: Dacryoendoscopy could be performed in all patients included in the study. Concerning the localization of stenoses, 48% of the patients were found to have complete post-saccal stenosis, 20% stenoses of the canaliculus, 10% combined complete post-saccal stenosis and partial stenosis of the canaliculus and 2% a partial stenosis of the distal lacrimal duct. In 18% of the patients no definitive location could be found using dacryoendoscopy. The localization of the stenosis determined with dacryoendoskopy correlated in 66,67% with the clinical diagnosis according to syringation, and in 70% with the localization of the stenosis as determined by dacryocystography. Endoscopy could provide additional information about pathologies of the lacrimal system, like lithiasis or polyposis. Conclusions: Dacryoendoscopy can provide valuable information under direct visualization of the lacrimal system. However it must be doubted whether the benefits of this method may justify to subsitute the other well established methods in the diagnostics of dacryostenoses.