Abstract
Purpose :
To evaluate the efficacy of dacryoendoscopy-guided silicone tube intubation by comparing the success rate of silicone tube intubation depending on the use of dacryoendoscopy, especially in terms of stenotic site, and identify the factors affecting the difference in success rate.
Methods :
We retrospectively reviewed the medical records of 168 patients (239 eyes) diagnosed with stenosis of the nasolacrimal pathway and had undergone silicone tube intubation between January 2020 to June 2022. Patients were divided into two groups depending on the use of dacryoendoscopy during the surgery. We compared the success rate of two groups according to obstructive site: Canaliculus and nasolacrimal duct. Success was defined as the disappearance of epiphora and the improvement of passage on the postoperative syringing test. The mantel-Haenszel chi-square test was used to analyze the success rate. In addition, we investigated cases of successful dacryoendoscopy-guided surgery that previously had failed in the conventional method.
Results :
Out of 239 eyes, 128 underwent dacryoendoscopy-guided silicone tube intubation, and 111 underwent surgery without dacryoendoscopy. The success rate was 65.77% in the group that underwent conventional surgery and 78.13% in the group that underwent dacryoendoscopy-guided surgery with a significant statistical difference(p=0.033). And whereas there is no significant difference of the success in the cases of nasolacrimal duct stenosis(67.39% vs. 75.29, p=0.333), in the cases of canalicular stenosis, the dacryoendoscopy-guided surgery group showed a higher success rate than the conventional surgery group. (64.62% vs. 83.72%, p=0.030) Successful dacryoendoscopic silicone tube intubation that previously had failed in conventional surgery is 12 cases, and 8 cases of which are the cases of canalicular stenosis. Some problems including missway, inflammation or discharge were resolved by finding the exact tract and removing the cause of stenosis with dacryoendoscopy.
Conclusions :
Dacryoendoscopy-guided silicone tube intubation is more effective to treat the cases of lacrimal pathway stenosis than a conventional method, especially in canalicular stenosis. Direct visualization of the pathway by dacryoendoscopy enables to resolve some problems unsolved in conventional silicone tube intubation.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.