Department of Orbit and Oculoplasty, Sankara Eye Hospital, Coimbatore, India.
Department of Ophthalmology, Sankara Eye Hospital, Coimbatore, India.
Korean J Ophthalmol. 2022 Aug;36(4):313-317. doi: 10.3341/kjo.2021.0141. Epub 2022 Jun 15.
To evaluate the outcome and efficacy of a modified technique of canaliculo-dacryocystorhinostomy (canaliculo-DCR) in the complete absence of lacrimal sac, as a means to reestablish lacrimal drainage in postdacryocystectomy (post-DCT) patients.
A retrospective, nonrandomized interventional study including 15 proven and established post-DCT patients with intact canaliculi of at least 7 to 8 mm. The patients presented with bothersome tearing to the oculoplastic clinic from January 2017 to January 2018. Patients were operated by a single surgeon (ST). Procedure involved creating a bony ostium of optimum size, internal membranectomy and the nasal mucosal flap anchored appropriately to create a passage in line with the common canaliculus. Adjunctively bicanalicular intubation and mitomycin-C were used.
Of the 15 patients who were operated (10 female and five male patients), 14 (93.33%) had functionally and anatomically patent lacrimal passage after the modified canaliculo-DCR, one (6.66%) was symptomatically better with partial regurgitation of clear fluid. Three (20%) had tube prolapse after 1st month postoperatively, which although significant, was not related to the technique. They were repositioned as an office procedure and retained thereafter till removal, no other tube related or mitomycin-C related sequelae was seen. No intraoperative complication was encountered.
With a success rate of 93.33% and a resultant patent lacrimal tear drainage passage and trivial complication such as tube prolapse, we can conclude, this technique of modified canaliculo-DCR in post-DCT patients is a safe and effective procedure with promising results, thereby avoiding cumbersome methods and maintenance of Jones tube while at the same time providing symptomatic relief to the patients.
评估在完全缺乏泪囊的情况下改良的泪道-鼻腔吻合术（泪囊-DCR）的疗效，作为重建泪囊切除术后（post-DCT）患者泪液引流的一种方法。
回顾性、非随机干预研究纳入了 15 例经证实的、有完整泪小管（至少 7 至 8 毫米）的 post-DCT 患者。这些患者于 2017 年 1 月至 2018 年 1 月因流泪问题到眼整形科就诊。所有患者均由同一位外科医生（ST）进行手术。手术包括创建最佳大小的骨性造口、内膜切除术以及将适当固定的鼻腔黏膜瓣以与共同泪小管成一直线创建通道。辅助双泪小管插管和丝裂霉素 C 也被使用。
在接受改良泪囊-DCR 的 15 例患者中（10 名女性和 5 名男性），14 例（93.33%）功能性和解剖性泪道通畅，1 例（6.66%）症状明显改善，但有清亮液体部分反流。术后 1 个月有 3 例（20%）发生管脱出，但这与技术无关。它们通过门诊手术重新定位，并保留至取出，没有观察到其他与管或丝裂霉素 C 相关的并发症。没有术中并发症发生。
成功率为 93.33%，形成了通畅的泪液引流通道，并且只有轻微的并发症如管脱出，我们可以得出结论，这种改良的 post-DCT 患者的泪囊-DCR 技术是一种安全有效的方法，结果有前景，从而避免了繁琐的方法和琼斯管的维持，同时为患者提供了症状缓解。
