J Korean Ophthalmol Soc.  2012 Apr;53(4):493-498.

The Effects of Transcanalicular Diode Laser-Assisted Revision Surgery for Failed Dacryocystorhinostomy

• Yoo JH
• Lee H
• Shin HH
• Lee JM
• Jang MW
• Baek SH

Abstract

PURPOSE
To determine the intranasal causes of failed dacryocystorhinostomy (DCR) and the effects of transcanalicular diode laser-assisted revision surgery.
METHODS
Twenty-four patients (29 eyes) who underwent revision surgery for a failed DCR at the Department of Ophthalmology, Ansan Hospital, Korea University between March 2009 and February 2011 were included in the present retrospective study. The intranasal causes of failed DCR, the time of symptoms such as epiphora and discharge after DCR, success rates of revision surgeries and follow-up periods were evaluated.
RESULTS
Membranous obstruction was found in 25 eyes (86.2%) and was accompanied with granuloma in 10 eyes; these were the most common causes of failed DCR. The mean time for symptom development after DCR was 14.6 months, the success rate of the first revision surgery was 82.1% and good results were obtained in 5 eyes after the second revision surgery. Recurrence developed in 2 eyes, but symptoms improved after the lateral tarsal strip procedure.
CONCLUSIONS
Membranous obstruction was the most common intranasal cause of failed DCR and transcanalicular diode laser-assisted revision surgery produced good results. Additionally, in patients with persistent epiphora following anatomically-patent revisional surgery, lacrimal pump failure due to lower eyelid laxity should be considered and corrected.

Keyword

Failed dacryocystorhinostomy; Intranasal cause; Lacrimal pump failure; Transcanalicular diode laser-assisted revision surgery

MeSH Terms

Dacryocystorhinostomy
Eye
Eyelids
Follow-Up Studies
Granuloma
Humans
Korea
Lacrimal Apparatus Diseases
Ophthalmology
Recurrence
Retrospective Studies

Figure

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  Figure 1 (A) Membranous obstruction (endoscopic view), (B) Intraoperative endoscopic view of transcanalicular diode laser-assisted revision surgery.

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  Figure 2 A patient with lower eyelid laxity (A) and after lateral tarsal strip procedure (B).

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