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Can preoperative lacrimal endoscopic evaluation change the paradigm of conventional lacrimal surgery?

  • Oculoplastics and Orbit
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Abstract

Purpose

To evaluate the effectiveness of preoperative lacrimal endoscopic evaluation (LEE) of lacrimal duct system (LDS).

Design

Retrospective comparative case series

Methods

From March 2016 to February 2020, the charts of patients chosen to undergo endoscopic dacryocystorhinostomy (EDCR) or silicone tube intubation (STI) were reviewed retrospectively. Group 1 included patients that underwent EDCR, and group 2 included patients that underwent STI. Preoperative LEE was performed for all patients. In group 1, we compared the functional success rate for patients who had been converted to STI with the patients who had undergone EDCR. In group 2, we compared the functional success rate of STI with those who had had STI without LEE.

Results

In group 1, 19 (54.3%) eyes were converted to STI following LEE, and the functional success rate was 84.2%, which is not significantly different from that of the EDCR group following LEE (p = 0.608). The functional success rate of EDCR without LEE was not different from that of STI following LEE (p = 1.000). In group 2, five eyes (26.3%) were converted to EDCR following LEE. The group undergoing STI following LEE showed a significantly higher functional success rate (95.7%) than the group without LEE (66.6%, p = 0.023).

Conclusion

Preoperative LEE enables direct visualization of the LDS and helps to obtain more accurate diagnosis. This allows for the best surgical option based on LEE findings, which can contribute to better results. Therefore, LEE would be expected to change the paradigm of the classical management of LDS.

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References

  1. Singh S, Ali MJ (2019) A review of diagnostic and therapeutic dacryoendoscopy. Ophthalmic Plast Reconstr Surg 35(6):519–524. https://doi.org/10.1097/IOP.0000000000001404

    Article  PubMed  Google Scholar 

  2. Cohen SW, Prescott R, Sherman M, Banko W, Castillejos ME (1979) Dacryoscopy. Ophthalmic Surg 10(11):57–63

    CAS  PubMed  Google Scholar 

  3. Sasaki T, Nagata Y, Sugiyama K (2005) Nasolacrimal duct obstruction classified by dacryoendoscopy and treated with inferior meatal dacryorhinotomy. Part I: positional diagnosis of primary nasolacrimal duct obstruction with dacryoendoscope. Am J Ophthalmol 140(6):1065–1069. https://doi.org/10.1016/j.ajo.2005.07.038

  4. Sasaki T, Nagata Y, Sugiyama K (2005) Nasolacrimal duct obstruction classified by dacryoendoscopy and treated with inferior meatal dacryorhinotomy: Part II Inferior meatal dacryorhinotomy. Am J Ophthalmol 140(6):1070–1074. https://doi.org/10.1016/j.ajo.2005.07.039

    Article  PubMed  Google Scholar 

  5. Mills DM, Meyer DR (2006) Acquired nasolacrimal duct obstruction. Otolaryngol Clin North Am. 39(5):979–99, vii. https://doi.org/10.1016/j.otc.2006.07.002

  6. Nemet AY, Wilcsek G, Francis IC (2007) Endoscopic dacryocystorhinostomy with adjunctive mitomycin C for canalicular obstruction. Orbit 26:97–100

    Article  Google Scholar 

  7. Linberg JV, McCormick SA (1986) Primary acquired nasolacrimal duct obstruction. A clinicopathologic report and biopsy technique. Ophthalmology 93(8):1055–63. https://doi.org/10.1016/s0161-6420(86)33620-0

  8. Kashkouli MB, Rezaee R, Nilforoushan N, Salimi S, Foroutan A, Naseripour M (2008) Topical antiglaucoma medications and lacrimal drainage system obstruction. Ophthalmic Plast Reconstr Surg 24(3):172–175. https://doi.org/10.1097/IOP.0b013e3181706829

    Article  PubMed  Google Scholar 

  9. Jawaheer L, MacEwen CJ, Anijeet D (2017) Endonasal versus external dacryocystorhinostomy for nasolacrimal duct obstruction. Cochrane Database Syst Rev 2:CD007097. https://doi.org/10.1002/14651858.CD007097.pub3

  10. Lee JJ, Lee HM, Lim HB, Seo SW, Ahn HB, Lee SB (2017) Learning curve for endoscopic endonasal dacryocystorhinostomy. Korean J Ophthalmol 31(4):299–305

    Article  Google Scholar 

  11. Shermetaro C, Gladstone GJ (1994) Adult nasolacrimal duct obstruction. J Am Osteopath Assoc 94(3):229–232

    CAS  PubMed  Google Scholar 

  12. Wearne MJ, Pitts J, Frank J, Rose GE (1999) Comparison of dacryocystography and lacrimal scintigraphy in the diagnosis of functional nasolacrimal duct obstruction. Br J Ophthalmol 83(9):1032–1035. https://doi.org/10.1136/bjo.83.9.1032

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Munk PL, Lin D, Morris DC (1990) Epiphora: treatment by means of dacryocystoplasty with balloon dilation of the nasolacrimal drainage apparatus. Radiology 177(3):687–690

    Article  CAS  Google Scholar 

  14. Lim SW, Sung YJ, Lew H (2017) Clinical efficacy of lacrimal endoscopy in patients with epiphora. J Korean Ophthalmol Soc 58(5):495–502

    Article  Google Scholar 

  15. Zheng Q, Shen T, Luo H, Hong C, He J, Gong J, Jiang J (2019) Application of lacrimal endoscopy in the diagnosis and treatment of primary canaliculitis: practical technique and graphic presentation. Medicine 98(33). https://doi.org/10.1097/MD.0000000000016789

  16. Singh S, Mittal V, Vashist U, Mittal R, Narang P (2019) Utility of intraocular endoscope for lacrimal canaliculi and sac examination. Int Ophthalmol 39(8):1879–1883. https://doi.org/10.1007/s10792-018-1017-9

    Article  PubMed  Google Scholar 

  17. Javate RM, Pamintuan FG, Cruz RT Jr (2010) Efficacy of endoscopic lacrimal duct recanalization using microendoscope. Ophthalmic Plast Reconstr Surg 26(5):330–333. https://doi.org/10.1097/IOP.0b013e3181c7577a

    Article  PubMed  Google Scholar 

  18. Mimura M, Ko AC, Alameddine RM (2020) Newly designed universal trans-punctal rigid lacrimal microendoscope. Ophthalmic Plast Reconstr Surg. https://doi.org/10.1097/IOP.0000000000001653

    Article  PubMed  Google Scholar 

  19. Mullner K, Bodner E, Mannor GE (1999) Endoscopy of the lacrimal system. Br J Ophthalmol 83(8):949–952. https://doi.org/10.1136/bjo.83.8.949

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Kim C, Kacker A, Levine B, Lelli GJ (2013) Lacrimal system endoscopy assisted endonasal dacryocystorhinostomy. Orbit 32(3):156–160. https://doi.org/10.3109/01676830.2013.771683

    Article  PubMed  Google Scholar 

  21. Lee SM, Lew H (2020) Transcanalicular endoscopic dacryoplasty in patients with primary acquired nasolacrimal duct obstruction. Graefes Arch Clin Exp Ophthalmol. https://doi.org/10.1007/s00417-020-04833-2

    Article  PubMed  PubMed Central  Google Scholar 

  22. Fujimoto M, Ogino K, Matsuyama H, Miyazaki C (2016) Success rates of dacryoendoscopy-guided probing for recalcitrant congenital nasolacrimal duct obstruction. Jpn J Ophthalmol 60(4):274–279. https://doi.org/10.1007/s10384-016-0445-1

    Article  PubMed  Google Scholar 

  23. Matsumura N, Suzuki T, Goto S, Fujita T, Yamane S, Muramaya M, Kadnosono K (2019) Transcanalicular endoscopic primary dacryoplasty for congenital nasolacrimal duct obstruction. Eye (Lond) 33(6):1008–1013. https://doi.org/10.1038/s41433-019-0374-6

    Article  Google Scholar 

  24. Heichel J, Bredehorn-Mayr T, Stuhltraeger U, Struck H (2015) Dacryoendoscopy for lacrimal duct obstruction manifesting in childhood. J Clin Exp Ophthalmol 6(394):2

    Google Scholar 

  25. Jung WH, Lee JH, Kim YJ, Yang JW (2020) Silicone tube intubation with lacrimal endoscopy and endonasal dacryocystorhinostomy in adult nasolacrimal duct obstruction. J Korean Ophthalmol Soc 61(11):1257–1264. https://doi.org/10.3341/jkos.2020.61.11.1257

    Article  Google Scholar 

  26. Ali MJ (2015) Dacryoendoscopic guided canalicular and nasolacrimal duct recanalization. In: Ali MJ (ed) Principles and Practice of Lacrimal Surgery. Springer, New Delhi, pp 309–317

  27. Anderson RL, Edwards JJ (1979) Indications, complications and results with silicone stents. Ophthalmology 86(8):1474–1487. https://doi.org/10.1016/s0161-6420(79)35374-x

    Article  CAS  PubMed  Google Scholar 

  28. Bartley GB (1993) Acquired lacrimal drainage obstruction: an etiologic classification system, case reports, and a review of the literature. Part 3. Ophthalmic Plast Reconstr Surg 9(1):11–26

  29. Beigi B, Uddin JM, McMullan TF, Linardos E (2007) Inaccuracy of diagnosis in a cohort of patients on the waiting list for dacryocystorhinostomy when the diagnosis was made by only syringing the lacrimal system. Eur J Ophthalmol 17(4):485–489. https://doi.org/10.1177/112067210701700401

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Minwook Chang.

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Ethics approval

The study was approved by the Institutional Review Board of Dongguk University, Ilsan Hospital, Goyang, South Korea (Approval number, DUIH 2021–00-000), and adhered to the tenets of the Declaration of Helsinki.

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The informed consent required was waived because of the retrospective nature and the minimal risk of this study.

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The authors declare no competing interests.

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Lee, S.J., Lee, K.M. & Chang, M. Can preoperative lacrimal endoscopic evaluation change the paradigm of conventional lacrimal surgery?. Graefes Arch Clin Exp Ophthalmol 260, 591–597 (2022). https://doi.org/10.1007/s00417-021-05366-y

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  • DOI: https://doi.org/10.1007/s00417-021-05366-y

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