Yuksel Dilek, Kosker Mustafa, Akoz Irem, Simsek Saban
Department of Ophthalmology, Ministry of Health, Ankara Training and Research Hospital , Ankara , Turkey .
Semin Ophthalmol. 2015 Jan;30(1):20-4. doi: 10.3109/08820538.2013.810282. Epub 2013 Nov 19.
To evaluate the long-term results of simultaneous bilateral external dacryocystorhinostomy (EX-DCR) in cases with bilateral dacryostenosis.
Thirty-four eyes of 17 consecutive patients with a history of bilateral epiphora were included in the study between 2007 and 2011. Demographic information, etiology of the obstruction, history of lacrimal surgery, type of anesthesia, duration of surgery, incidence of postoperative nasal bleeding and infection, surgical outcomes, and duration of follow-up were recorded. During the lacrimal irrigation, there was not any passage noticed in the patients' eyes. The post-operative follow-up was 13 to 44 months (mean 33.6 months).
Of 17 patients undergoing simultaneous bilateral EX-DCR with a mean age of 42.8 years, one of the patients had a history of bilateral unsuccessful DCR performed in a different center. One patient had previously failed bilateral probing before undergoing bilateral EX-DCR. This latter patient was a four-month-old baby with bilateral dacryoceles. Bicanalicular silicone intubation was performed in 15 eyes of 10 patients that had a canalicular problem or fibrotic lacrimal sac. It has been discerned that complaints about epiphora disappeared in 33 of the eyes (97%) and that the passage was open during the lacrimal irrigation. One eye with a history of unsuccessful dacryocystorhinostomy failed to respond positively to our operation.
In our study, high success rates of simultaneous bilateral EX-DCR were found in both children and adult patients with bilateral dacryostenosis during a long-term follow-up. We believe that simultaneous bilateral dacryocystorhinostomy has medical, social, and economic advantages.
评估双侧泪道狭窄患者同期双侧外路泪囊鼻腔造口术（EX-DCR）的长期效果。
2007年至2011年期间，连续纳入17例有双侧溢泪病史患者的34只眼进行研究。记录人口统计学信息、阻塞病因、泪道手术史、麻醉类型、手术时长、术后鼻出血和感染发生率、手术结果及随访时长。泪道冲洗时，患者眼中均未见任何通畅情况。术后随访时间为13至44个月（平均33.6个月）。
17例接受同期双侧EX-DCR的患者，平均年龄42.8岁，其中1例患者曾在其他中心进行双侧DCR手术但未成功。1例患者在接受双侧EX-DCR之前双侧探通术失败。该患者为一名4个月大患有双侧泪囊膨出的婴儿。10例存在泪小管问题或泪囊纤维化的患者的15只眼中进行了双泪小管硅胶插管。已发现33只眼（97%）的溢泪症状消失，且泪道冲洗时通道通畅。1例有泪囊鼻腔造口术失败史的眼睛对我们的手术未产生积极反应。
在我们的研究中，双侧泪道狭窄的儿童和成人患者在长期随访中同期双侧EX-DCR均有较高成功率。我们认为同期双侧泪囊鼻腔造口术具有医学、社会和经济优势。
