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Kazuyoshi Ohtomo; Effect of Nunchaku-Style Silicon Tube Intubation in Patients with Lacrimal Duct Obstruction Associated with S-1.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):688.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate clinical features of lacrimal duct obstruction associated with S-1 (LDOAS) and the prognostic factors of direct silicon tube intubation (DSI) with Nunchaku-style silicon tube.
Of 26 patients (15 males and 11 females), 52 eyes with a LDOAS who had an operation between 2008 and 2014 were evaluated retrospectively. The severity of canalicular obstruction was assigned as a degree of canalicular obstruction. Patients were categorized into an effective group defined as disappearance of epiphora and improvement of lacrimal passage and an ineffective group including re-occlusions and insertion failures which were not able to insert the NST.
The mean age was 64.5±7.1(mean±SD). Average followed-up period was 18.1±21.2 months. The mean duration of S-1 administration was 14.0±11.8months. The mean period until symptom appearance was 4.9±3.5 months. The frequency of epithelial disorder of cornea before the treatment was 42%. The S-1 administration was 58%. The obstructed parts including duplication were found in punctum (19%), canaliculous (65%), common canaliculous (13%), lacrimal suc (4%), and nasolacrimal duct (15%). The mean severity of canaliculous obstruction was 3.6±2.3.DSI was effective in 29 eyes (56%). There were significant differences on followed-up period (p=0.0007, Mann-Whitney U test), the duration of S-1 administration (p=0.0041, Mann-Whitney U test), the period until symptom appearance (p=0.0032, Mann-Whitney U test), and the frequency of corneal epithelial disorder (p=0.0240, Fisher’s Exact test) between the effective and the ineffective groups. In the obstructed parts, there were significant differences on canaliculous (p<0.0001, Fisher’s Exact test), common canaliculous (p=0.0064, Fisher’s Exact test), nasolacrimal duct (p=0.0064, Fisher’s Exact test). In the severity of canaliculous, the ineffective group was more severe obstruction than the effective group (p<0.0001, Mann-Whitney U test). In the multiple regression analysis, there was a significant difference on the severity of canaliculous (OR=5.69, p=0.0006, 95%CI=2.5412-18.998).
Patients with a LDOAS had mainly canaliculous obstruction (65%). DSI was effective in 29 eyes (56%). Our findings showed that the severity of canaliculous obstruction became the prognostic factor of DSI.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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