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Kim and Kim: The Surgical Results of Endonasal DCR with Two Silicone Tubes in Common Canalicular Obstruction
Original Article

J Korean Ophthalmol Soc 2007;48(9):1170-1176.

Published online: 30 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.9.1170

The Surgical Results of Endonasal DCR with Two Silicone Tubes in Common Canalicular Obstruction

Se Jong Kim, M.D., Sang Duck Kim, M.D., Ph.D.

Department of Ophthalmology, Wonkwang University College of Medicine, Iksan, Korea

Address Reprint requests to Sang Duck Kim, M.D., Department of Ophthalmology, College of Medicine, Wonkwang University Hospital, #344-2 Sinyoung-dong, Iksan-si, Jeonbuk 570-711, Korea, Tel: 82-63-589-1383, Fax: 82-63-859-1801, E-mail: sangduck@wonkwang.ac.kr

Received 21 November 2006       Accepted 29 May 2007

Copyright © 2007 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the surgical results of endonasal dacrocystorhinostomy with two silicone intubation in common canalicular obstruction.

Methods

Forty patients (57 eyes) who complained of tearing due to common canalicular obstruction underwent endonasal dacryocystorhinostomy. In this study, We randomly divided patients into two groups. One group underwent one-silicone tube intubation (29 eyes, group A) and the other group underwent two-silicone tube intubation (28 eyes, group B). After surgery, we compared the success rates and the causes of surgical failure between the two groups.

Results

There were no significant differences between the two groups with regard to age, sex, duration of silicone intubation, or follow-up time. The primary success rates of the group A and the group B were 65.5% (19/29) and 85.7% (24/28) [(P=0.078)], respectively. the final success rates after the revisional surgery were 76.4% (21/29) and 92.8% (26/28) [(P=0.043)] respectively. Primary causes of surgical failure in the group A were: membranous obstruction of the internal ostium (6), common canalicular re-obstruction (2), sump syndrome (1), and functional obstruction (1). The main causes of surgical failure in the group B were: membranous obstruction of the internal ostium (2), and granuloma formation (2).

Conclusions

We believe that endonasal dacryocystorhinostomy with two-silicone tube intubation might be an excellent alternative treatment modality in order to improve success rates in common canalicular obstruction.

Keywords: Common canalicular obstruction, Endonasal dacryocystorhinostomy, Two-silicone tubes

References

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Figure 1.
Dacryocystogram demonstrating right common canalicular obstruction.
jkos-48-1170f1.tif
Table 1.
Demographies of 40 patients who undergone 57 endonasal DCR surgeries for common canalicular obstruction
Age (yrs) (mean±SD) 60.73± 11.34
Gender
  [N∗ (no. of eyes)]
 Male 5 (6)
 Female 35 (51)
 Total 40 (57)
Surgery
  [N∗ (no. of eyes)]
 One silicone tube 20 (29)
 Two silicone tubes 20 (28)
Stent removal (months) (mean±SD) 3.86±0.60
Follow-up time
 after stent removal (months) (mean±SD) 6.54±1.14
Primary Success Rate 75.4% (43/57)
Final Success Rate 82.4% (47/57)

∗ :number of patients.

Table 2.
Comparison of baseline characteristics
Group A Group B P
Age (yrs) [mean±SD] 59.24±10.95 62.29± 11.73 non-significant
Gender [N∗ (no. of eyes)]
 Male 3 (3) 2 (3)
 Female 17 (26) 18 (25)
 Total 20 (29) 20 (28) non-significant
Stent removal (months) [mean±SD] 3.90±0.56 3.82±0.67 0.647
Follow-up time
 after stent removal (months) [mean±SD] 6.62± 1.27 6.46±1.04 0.612

Group A: one silicone tube intubation.

Group B: two silicone tube intubation.

P value was calculateded by unpaired t-test.

∗ :number of patients.

Table 3.
Comparison of surgery outcome
Group A Group B P
Tearing [no of eyes]
 Good 16 22
 Fair 4 3
 Poor 9 3
 Total 29 29
Lacrimal irrigation [no of eyes]
 Good 20 22
 Fair 2 2
 Poor 7 4
 Total 29 28
Primary Success Rate 65.5% (19/29) 85.7% (24/28) 0.078
Final Success Rate 76.4% (21/29) 92.8% (26/28) 0.043

Group A: one silicone tube intubation.

Group B: two silicone tube intubation.

P value was calculateded by chi-square test.

Table 4.
Factors of postoperative failure and number of eyes
Group A Group B
Membranous obstruction of internal ostium 6 (5) 2
Granuloma 0 2 (0)
Common canalicular reobstruction 2 0
Sump syndrome 1 (0) 0
Functional obstruction 1 0

Group A: one silicone tube intubation.

Group B: two silicone tube intubation.

(): Final number of eyes after re-operation.

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