J Korean Ophthalmol Soc.  2018 Apr;59(4):301-306. 10.3341/jkos.2018.59.4.301.

Surgical Outcomes of Endonasal Dacryocystorhinostomy According to the Level of Obstruction in Dacryocystography

Affiliations
  • 1Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea. ahnmin@jbnu.ac.kr
  • 2Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea.
  • 3Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.

Abstract

PURPOSE
The success of endonasal dacryocystorhinostomy was assessed according to the level of tear duct obstruction in dacryocystography.
METHODS
Patients visited our clinic with the chief complaint of epiphora between January 2009 and September 2016 who received dacryocystography and were diagnosed with a total nasolacrimal obstruction. Among these patients, 128 eyes from 115 patients who received endonasal dacryocystorhinostomy were selected and their medical records from > 6-month follow-ups were analyzed retrospectively. The patients were divided into four groups according to the level of lacrimal passage obstruction in dacryocystography: common canaliculus obstruction as group 1, lacrimal sac obstruction as group 2, lacrimal sac-nasolacrimal duct junction obstruction as group 3, and nasolacrimal duct obstruction as group 4. Success and failure were determined according to symptom improvements after surgery.
RESULTS
Among the total of 128 eyes, 19 eyes were categorized as group 1 (22.6%), 28 eyes as group 2 (21.9%), 28 eyes as group 3 (21.9%), and 43 eyes as group 4 (33.6%). Nasolacrimal duct obstruction was the most common condition. The success of endonasal dacryocystorhinostomy was 55.2% in group 1, 71.4% in group 2, 85.7% in group 3, and 86.1% in group 4. The surgical success of the patient group with common canaliculus obstruction was significantly lower than the surgical success of the lacrimal sac-nasolacrimal duct junction obstruction and nasolacrimal duct obstruction groups (p = 0.03 and p = 0.01, respectively).
CONCLUSIONS
Determination of the accurate position of obstruction using preoperative dacryocystography is recommended for patients with epiphora caused by tear duct obstruction because this predicted the effects of endonasal dacryocystorhinostomy.

Keyword

Dacryocystography; Dacryocystorhinostomy; Nasolacrimal obstruction

MeSH Terms

Dacryocystorhinostomy*
Follow-Up Studies
Humans
Lacrimal Apparatus Diseases
Lacrimal Duct Obstruction
Medical Records
Nasolacrimal Duct
Retrospective Studies
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