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Dacryoendoscopic surgery and tube insertion in patients with common canalicular obstruction and ductal stenosis as a frequent complication

  • Clinical Investigation
  • Published:
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Abstract

Purpose

To report the performance of a new technique and strategy for treating common canalicular obstruction (CCO). Since ductal stenosis is a frequent complication of CCO, access to the whole lacrimal passage is important for CCO treatment.

Methods

In a retrospective, nonrandomized clinical trial, 46 patients (57 CCO cases, 42–93 years old) were treated with either dacryoendoscopic canalicular incision (EI) dacryoendoscope-guided tube insertion (EGT), EI plus inferior meatal dacryocystorhinostomy (iDR)/EGT, EI plus endonasal dacryocystorhinostomy (enDCR), or external canaliculo-DCR depending on the degree of ductal stenosis. The dacryoendoscope was used for incisional positioning, examination and guidance.

Results

Ductal stenoses/obstructions were complicated in 14 of 57 CCO cases (24.5%). The success rate after 6–25 months of postoperative follow-up was 89.5% (51/57 cases). The success rates after EI/EGT alone, EI plus enDCR, and EI/EGT plus iDR were 90.4% (38/42 cases), 100% (4/4 cases), and 90% (9/10 cases), respectively. In one case, false passages through the submucosa of the canaliculi were identified, and the surgical approach was converted from EI/EGT to canaliculo-DCR.

Conclusions: EI/EGT alone is an effective, minimally invasive method for treatment of simple CCO. Additional lacrimal surgery (iDR/EGT, enDCR, and canaliculo-DCR) is effective for complicated CCO

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Authors and Affiliations

  1. Department of Ophthalmology, Kanazawa University School of Medicine, Kanazawa, Japan

    Tsugihisa Sasaki, Tsutomu Sounou & Kazuhisa Sugiyama

  2. Sasaki Eye Clinic, Mikuni, Sakai, Japan

    Tsugihisa Sasaki

  3. Department of Ophthalmology, NTT West Japan Kanazawa Hospital, Kanazawa, Japan

    Tsutomu Sounou

  4. Department of Ophthalmology, Fukui Prefectural Hospital, Fukui, Japan

    Tsugihisa Sasaki

  5. Sasaki Eye Clinic, 5-2-6 Mikuni, Sakai, 913-0016, Japan

    Tsugihisa Sasaki

Authors
  1. Tsugihisa Sasaki
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  2. Tsutomu Sounou
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  3. Kazuhisa Sugiyama
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Correspondence to Tsugihisa Sasaki.

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Sasaki, T., Sounou, T. & Sugiyama, K. Dacryoendoscopic surgery and tube insertion in patients with common canalicular obstruction and ductal stenosis as a frequent complication. Jpn J Ophthalmol 53, 145–150 (2009). https://doi.org/10.1007/s10384-008-0624-9

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  • DOI: https://doi.org/10.1007/s10384-008-0624-9

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