Journal List > J Korean Ophthalmol Soc > v.49(11) > 1008121

Tae and Jung: Clinical Usefulness of Laser Cystectomy

Abstract

Purpose

To evaluate the usefulness of laser cystectomy for the treatment of patients with dacryocystitis and sump syndrome.

Methods

Thirteen patients (13 eyes) diagnosed with acute or chronic dacryocystitis, and nine patients (9 eyes) who developed sump syndrome after dacryocystorhinostomy from 2005 to 2006 underwent laser cystectomy and endonasal dacryocystorhinostomy.

Results

Pain and swelling around the orbit improved immediately after the operation in patients with acute dacryocystitis, and all symptoms of sump syndrome disappeared by 1 month postoperatively. Epiphora reduced in all patients. During the follow-up period, functional nasolacrimal duct obstruction occurred in one eye and membranous obstruction developed in two eyes. In these two eyes with membranous obstruction, revisional surgery was performed successfully. No recurrence of dacryocystitis was noticed.

Conclusions

Laser cystectomy with endonasal dacryocystorhinostomy is a simple and effective treatment modality for patients with dacryocystitis and sump syndrome that minimizes the risk of recurrence.

References

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Figure 1.
Delayed view of dacryocystography demonstrates contrast overflowing into the nose after filling the residual lacrimal sac (white arrow).
jkos-49-1717f1.tif
Figure 2
. Schematic illustration of laser cystectomy. (A) Nd:YAG laser probe is introduced through the lower punctum and lower canaliculus to evaporate epithelium of the lacrimal sac. (B) Final appearance of the laser cystectomy. Note the complete removal of the lacrimal sac.
jkos-49-1717f2.tif
Table 1.
Patient characteristics
Dacryocystitis with NLD obstruction Sump syndrome All
Patients (Eyes) 12 (12) 10 (10) 22 (22)
Male/Female (Patients) 4/8 1/9 5/17
Mean Age (Years) 54.55±11.14 51±16.65 53.05±13.76
Mean follow-up period (Months) 21±6.93 13±7.58 17±8.07
Table 2.
Surgical success rates
Dacryocystitis with NLD obstruction Sump syndrome
Primary Operation 91.7% (11/12) 90% (9/10)
Secondary Operation 100% (1/1) 100% (1/1)
Final 100% (12/12) 100% (10/10)
Table 3.
Postoperative complications
Dacryocystitis with NLD obstruction Sump syndrome
Membranous obstruction 1/12 1/10
Synechia - 2/10
Granuloma 6/12 1/10
Tenderness over lacrimal fossa - -
Rhinitis - -
Loss of silicone tube - -
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