Scintigraphic evaluation for tear drainage, after dacryocystorhino- stomy, in relation to patient satisfaction.

AIM

To measure the degree of physiological patency of the tear drainage system using dacryoscintigraphy before and after external dacryocystorhinostomy (EDCR) in relation to patient complaints.

METHODS

Prospective evaluation of 29 eyes of 24 patients with primary acquired nasolacrimal duct obstruction (PANDO) who underwent EDCR. The epiphora complaints were measured subjectively. Dacryoscintigraphy was performed in all eyes preoperatively, and was repeated 6 months after DCR together with the complaints score. For evaluation of dacryoscintigraphy, we determined T1 (percentage of administered dose still present after 1 min) and linear clearance rate (LCR), defined as: 100%(T1-T15)/T1) from the tracer disappearance curve. Dacryoscintigraphy findings were compared with the results of 20 eyes of normal volunteers without any symptoms. Scintigraphic findings were compared before and after the operation, with the change in patient complaints score as well as with normal values.

RESULTS

Significant improvement occurred after the operation in the complaints score, T1 and LCR. However, despite absence of complaints (score=0) postoperative scintigraphic values were still abnormal as compared to normal individuals.

CONCLUSION

Despite almost complete remission of epiphora complaints, DCR does not result in normalization of the tear drainage system.