Correction: Retrospective analysis of bicanalicular lacrimal silicone tube intubation in patients with congenital nasolacrimal duct obstruction: a long-term follow-up study
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Correction to: Retrospective Analysis of Bicanalicular Lacrimal Silicone Tube Intubation in Patients with Congenital Nasolacrimal Duct Obstruction: A Long-term Follow-up StudyKlin Monbl Augenheilkd eFirstDOI: 10.1055/a-2237-1139Keywords:
Nasolacrimal Duct Obstruction
Nasolacrimal duct
The inborn nasolacrimal duct obstruction is common ocular disease in new-borns and infants. There are still doubts concerning the timing of the operating procedure. Probing of the lacrimal ducts is the therapeutic method for this condition.To evaluate the therapy outcome in congenital nasolacrimal duct obstruction in authors' own material.In retrospective study of 3950 medical records of children from our Outpatient's Clinic, we distinguished 192 children with nasolacrimal duct obstruction. Then, we evaluated the outcome of implemented treatment in correlation with their age and timing of the nasolacrimal duct probing.All children with nasolacrimal duct obstruction had mucopurulent discharge in the lacrimal sac and lacrimation. After the conventional treatment, the disease resolved in 23% of our group, whereas, in the rest of the patients probing of the nasolacrimal duct was implemented. The probing was successful in all children, but it was necessary to repeat the procedure twice in 13 children and three times in 5 children. The success rate of single probing was as follows: 91% in the group of children 1 - 3 months old, 83% in both groups: 3 - 6 and 6 - 12 months old and 71% in the oldest group of children - above 1 year of age.In majority of children the nasolacrimal duct obstruction did not resolve spontaneously. Early probing within first few months of child's life increased the success rate of this procedure.
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PURPOSE: To evaluate the long-term efficacy of silicone intubation in adults with presumed functional nasolacrimal duct obstruction.METHODS: This retrospective cohort study reviewed adults with unilateral or bilateral epiphora and presumed functional nasolacrimal duct obstruction treated with silicone intubation and followed for signs of treatment failure (defined as persistent epiphora or need for a secondary procedure). Median time to event (failure) after silicone intubation was calculated using Kaplan-Meier survival analysis. Analysis was conducted at the level of the individual eye, with clustering by person taken in account. Cox proportional hazards models were used and adjusted for within-subject variance using a robust sandwich estimator.RESULTS: Forty-four eyes from 30 patients with isolated functional nasolacrimal duct obstruction underwent silicone intubation for epiphora. Mean time to stent removal in 40 of 44 eyes was 4.0 (±4.1) months. Mean duration from the time of stent placement to last follow-up was 2.6 (±2.0) years. Overall success after silicone intubation for resolution of symptoms was 77%. Kaplan-Meier survival analysis for time to event after silicone intubation yielded a median time of 5.7 years. Extrapolated data demonstrated a 96% success rate at 2 years and 85% success rate at 3 years and predicted approximately 50% of patients to have relief of epiphora between 5 and 6 years after silicone intubation.CONCLUSIONS: In this study, silicone intubation has good long-term success for relief of epiphora in patients with presumed functional nasolacrimal duct obstruction. This study provides important clinical information to guide management of epiphora in adults with functional nasolacrimal duct obstruction. PMID: 22262288
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Purpose: This study investigated the cytological findings of the nasolacrimal duct by using the removed silicone tube in patients of nasolacrimal duct obstruction according to the surgical technique. Methods: Cytologic study was performed in 49 eyes of 41 patients who underwent silicone tube intubation or dacryocystorhinostomy from May 2002 to April 2003. By using Thin Prep 2000 (CYTYC. USA), the cells around the removed silicone tube inserted in the operation were observed by light microscope. The patients were classified into the silicone tube intubation group and the dacryocystorhinostomy group. Differences of observed cytological results were analyzed by the Pearson Chi-Square test. Results: From the cytological results by the type of operation, there was no statistical difference between the silicone tube intubation group and the dacryocystorhinostomy group, and the frequency of hyphae detection was higher in the dacryocystorhinostomy group than in the silicone tube intubation group (p
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Purpose: To evaluate the long-term efficacy of silicone intubation in adults with presumed functional nasolacrimal duct obstruction. Methods: This retrospective cohort study reviewed adults with unilateral or bilateral epiphora and presumed functional nasolacrimal duct obstruction treated with silicone intubation and followed for signs of treatment failure (defined as persistent epiphora or need for a secondary procedure). Median time to event (failure) after silicone intubation was calculated using Kaplan-Meier survival analysis. Analysis was conducted at the level of the individual eye, with clustering by person taken in account. Cox proportional hazards models were used and adjusted for within-subject variance using a robust sandwich estimator. Results: Forty-four eyes from 30 patients with isolated functional nasolacrimal duct obstruction underwent silicone intubation for epiphora. Mean time to stent removal in 40 of 44 eyes was 4.0 (±4.1) months. Mean duration from the time of stent placement to last follow-up was 2.6 (±2.0) years. Overall success after silicone intubation for resolution of symptoms was 77%. Kaplan-Meier survival analysis for time to event after silicone intubation yielded a median time of 5.7 years. Extrapolated data demonstrated a 96% success rate at 2 years and 85% success rate at 3 years and predicted approximately 50% of patients to have relief of epiphora between 5 and 6 years after silicone intubation. Conclusions: In this study, silicone intubation has good long-term success for relief of epiphora in patients with presumed functional nasolacrimal duct obstruction. This study provides important clinical information to guide management of epiphora in adults with functional nasolacrimal duct obstruction.
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Objective To evaluate the efficacy of recessive placement of nasolacrimal stent in the treatment of nasolacrimal duct obstruction and factors affecting the prognosis of the procedure.Design Retrospective case series.Participants One hundred eighty six patients(207 eyes) with nasolacrimal duct obstruction.Methods One hundred eighty six patients(207 eyes) of nasolacrimal duct obstruction confirmed by dacryocystography had undergone recessive placement of nasolacrimal stent after probing and dilation of nasolacrimal duct.All patients received regular postoperative nasolacrimal duct syringe.Main Outcome Measures Status of postoperative lacrimal syringe.Results The stents were removed 3～12 months postoperatively,the patients were followed-up average 6 months.The operation success rate was 97.1%.167 eyes achieved complete success(80.7%).25 eyes became better(12.1%),and nasolacrimal duct obstructed again in 15 cases(7.2%).Conclusions Recessive placement of nasolacrimal stent combined with postoperative nasolacrimal duct syringe is a simple,effective and safe technique in the treatment of nasolacrimal duct obstruction.Selecting correct patients,skillful technique of nasolacrimal duct probing and regular postoperative syringing of nasolacrimal duct are the main factors of successful procedures.
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Clinic observation of 108 cases of nasolacrimal stent implantation for nasolacrimal duct obstruction
Objective To observe the efficacy and practicability of the treatment for nasolacrimal duct obstruction with nasolacrimal stent implantation.Methods One hundred and eight cases(108 eyes)of nasolacrimal duct obstruction were placed nasolacrimal stent.All patients were divided into two groups according to postoperative follow-up time.Group A consisted of 57 cases and were observed for more than 3 years after operation.Group B consisted of 51 cases and were observed 6 months to 3 years.A chi-square test was used to compare these two groups.Results The cure rates of Group A and Group B were 80.7% and 82.3% respectively.There was no significant difference in cure rate between these two groups.Conclusions The treatment for nasolacrimal duct obstruction with nasolacrimal stent implantation is convenient method with higher successful rate,minimal tissue damage and simple appliance.
Key words:
Nasolacrimal stent; Nasolacrimal duct obstruction; Chronic dacryocystitis
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불완전 코눈물관막힘이 있는 성인 환자에서 실리콘관 삽입술의 장기효과 권용혁․이용재 울산대학교 의과대학 서울아산병원 안과학교실 목적 : 성인의 불완전 코눈물관막힘에서 실리콘관 삽입술은 현재 널리 시행되고 있으나, 장기간 경과관찰을 통한 성공 률에 대해서는 드물게 보고되고 있어 이를 보고하고자
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Abstract Background : Whether to choose nasolacrimal duct intubation or dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (PANDO) therapy is an important question in clinic practice. The purpose of this study is to find the potential lacrimal sac characteristics which can be used for the predictors of unsuccessful intubation for PANDO based on computed tomography-dacryocystography (CT-DCG). Methods : In this retrospective comparative observational study, we included PANDO patients who had a history of failed intubation for nasolacrimal duct obstruction as intubation failure group, and PANDO patients without intubation history as control group. We analyzed the lacrimal sac height, lacrimal sac width and obstruction site based on CT-DCG, all measured based on several reference levels on axial sections (upper, intermediate, lower level, common canaliculus level and lowermost contrast level), which were defined according to the contrast and the bony structure. Results: A total of 114 sides of PANDO were studied, including 36 sides in intubation failure group the other 78 sides in control group. The intubation failure group showed smaller lacrimal sac height (11.69±4.59 mm) and width (2.28±1.97 mm, intermediate level) than control group (14.13±2.92 mm, 3.32±2.02 mm, P = 0.005 and 0.012, respectively). Intubation failure group showed higher obstruction site than control group (P = 0.009). Conclusions : A small lacrimal sac and a high obstruction site are predictors of nasolacrimal duct intubation failure for PANDO. For PANDO patients with small lacrimal sac or high obstruction position, DCR is more recommended than intubation.
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Abstract Objective: To determine the success rate of initial probing in children with congenital nasolacrimal duct obstruction at different ages, using nasal endoscopy. Methods: Fifty eyes of 38 consecutive children with congenital nasolacrimal duct obstruction underwent endoscopic nasolacrimal duct probing under general anaesthesia. Patients were followed up for at least three months. Probing success was defined as complete remission of symptoms and a normal fluorescein dye disappearance test result. Results: The age range of patients was 17–109 months. The success rates of probing were: 100 per cent (29 out of 29) for cases of stenosis at the lower nasolacrimal duct, 100 per cent (7 out of 7) for functional epiphora cases and 92.86 per cent (13 out of 14) for nasolacrimal atresia cases. Overall, there was only one child for whom the probing treatment for nasolacrimal duct obstruction was not successful; this child had Down's syndrome and a more complex developmental abnormality of the nasolacrimal duct. Age and site of obstruction were not found to significantly affect the outcome of probing. Conclusion: Probing of the nasolacrimal system using an endoscopic approach allows direct visualisation of the nasolacrimal duct. This can facilitate diagnosis of the anomaly and significantly increase the procedure success rate.
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