The Result of Canaliculodacryocystorhinostomy with Double Probing in Common Canalicular Obstruction

Taek Hoon Lee; Myung Sook Ha; Sang Hyoung Cho

doi:10.3341/jkos.2008.49.1.1

Journal List > J Korean Ophthalmol Soc > v.49(1) > 1008150

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Lee, Ha, and Cho: The Result of Canaliculodacryocystorhinostomy with Double Probing in Common Canalicular Obstruction

Original Article

J Korean Ophthalmol Soc 2008;49(1):19-26.

Published online: 3 August 2008

DOI: https://doi.org/10.3341/jkos.2008.49.1.1

The Result of Canaliculodacryocystorhinostomy with Double Probing in Common Canalicular Obstruction

Taek Hoon Lee, M.D.¹, Myung Sook Ha, M.D.¹, Sang Hyoung Cho, M.D.²

¹Department of Ophthalmology, College of Medicine, Konyang University, Daejeon, Korea

²Noon-Cho-Eun Eye Clinic, Gyeonggi, Korea

Address reprint requests to Myung Sook Ha, M.D. Department of Ophthalmology, KonYang University Hospital #685 Gasuwon-dong, Seo-gu, Daejeon 302-718, Korea Tel: 82-42-600-9258, Fax: 82-42-600-9090, E-mail: hmseye@hanmail.net

Received 30 May 2007 Accepted 4 September 2007

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 results of endoscopic canaliculodacryocystorhinostomy with double probing to resolve common canalicular obstruction.

Methods

A total of 47 patients (56 eyes) with common canalicular obstruction underwent endoscopic canaliculodacryocystorhinostomy. The double probing method was applied to 28 eyes; the remaining 28 eyes were in the control group. The success rate, degree of symptom improvement, and complication rate of the two groups were compared and analyzed.

Results

The postoperative success rate was 96% in the group that underwent surgery with the double probing method and 86% in the control group (P=0.160). The rate of symptom improvement without tearing was 86% in the double probing method group and 61% in the control group (P=0.038). Postoperative complication rates such as granuloma formation were 7% and 29% in the study and control groups, respectively (P=0.036).

Conclusions

Endoscopic canaliculodacryocystorhinostomy with double probing to resolve common canalicular obstruction is proven to be effective in enhancing patient satisfaction and lowering complication rates, with no additional costs and risks.

Keywords: Canaliculodacryocystorhinostomy, Common canalicular obstruction, Double probing method

References

1. Jones LT. The cure of epiphora due to canalicular disorders: trauma and surgical failures on lacrimal passages. Trans Am Acd Ophthalmol Otolaryngol. 1962; 66:506–24.

2. Welham RAN. Canalicular obstructions and the Lester-Jones tube what to do when all else fails. Trans Ophthalmol Soc U K. 1973; 93:623–32.

3. Chandler AC, Wadsworth JA. Conjunctivodacryocystorhinostomy. Am J Ophthalmol. 1974; 77:830–6.

4. Pameijer JH, Henkes HE, Wildervanck de Blecourt P. Experiences with the Jones tube in the Rotterdam Eye Clinic. Ophthalmologica. 1975; 171:353–7.

5. White JH. The management of early lacrimal tube complications. Ophthalmic Surg. 1976; 7:29–30.

6. Lamping K, Levine MR. Jones tube: How good they are? Arch Ophthalmol. 1983; 101:260–1.

7. Skov CM, Mazow ML. Diplopia following Jones tube placement. Ophthalmic Surg. 1984; 15:932–3.

8. Burger D. Conjunctivodacryocystorhinostomy: Course or cure. Trans Ophthalmol Soc N Z. 1984; 36:59–65.

9. Welham RA, Guthoff R. The Lester Jones tube: A 15 year follow up. Graefes Arch Clin Exp Ophthalmol. 1985; 223:106–8.

10. Nissen JN, Sorensen T. Conjunctivorhinostomy: A study of 21 cases. Acta Ophthalmol. 1987; 65:30–6.

11. Bartley GB, Gustafson RO. Complications of malpositioned Jones tubes. Am J Ophthalmol. 1990; 109:66–9.

12. Steinsapir KD, Glatt HJ, Putterman AM. A 16-year study of conjunctival dacryocystorhinostomy. Am J Ophthalmol. 1990; 109:387–93.

13. Sekhar GC, Dortzbach RK, Gonnering RS, Lemke BN. Problems associated with conjunctivodacryocystorhinostomy. Am J Ophthalmol. 1991; 112:502–6.

14. Rose GE, Welham RA. Jones' lacrimal canalicular bypass tubes: twenty-five years' experience. Eye. 1991; 5:13–9.

15. Rosen N, Ashkenazi J, Rosner M. Patient dissatisfaction after functionally successful conjunctivodacryocystorhinostomy with Jones tube. Am J Ophthalmol. 1994; 117:636–42.

16. Abel AD, Meyer DR. Refractory medial conjunctival inflammation associated with Jones tube. Ophthalmic Plast Reconstr Surg. 2003; 19:309–12.

17. Lim C, Martin P, Benger R, et al. Lacrimal canalicular bypass surgery with the Lester Jones tube. Am J Ophthalmol. 2004; 137:101–8.

18. Yun JR, Chang HK. Long term follow up of conjunctivodacryocystorhinostomy. J Korean Ophthalmol Soc. 1996; 37:1583–9.

19. Yoo JR, Choi WC. A survey of post-operative satisfaction in patients with canalicular obstruction after Jones tube intubation. J Korean Ophthalmol Soc. 2002; 43:2081–8.

20. Pashby RC, Rathbun JE. Silicone tube intubation of the lacrimal drainage system. Arch Ophthalmol. 1979; 97:1318–22.

21. Busse H, Meyer-Rusenberg HW, Kroll P. Canaliculodacryocystotomy. Orbit. 1985; 4:69–72.

22. Hatt M. Surgery of acquired canalicular stenosis. Orbit. 1992; 11:153–6.

23. Dutton JJ, Holck DE. Holmium laser canaliculoplasty. Ophthalmic Plast Reconstr Surg. 1996; 12:211–7.

24. Song HY, Lee CO, Park S, et al. Lacrimal canalicular obstruction: Safety and effectiveness of balloon dilatation. J Vasc Interv Radiol. 1996; 7:929–34.

25. Ko GY, Lee DH, Ahn HS, et al. Balloon catheter dilation in common canalicular obstruction of the lacrimal system: Safety and long term effectiveness. Radiology. 2000; 214:781–6.

26. Sisler HA, Allarakhia L. New minitrephine makes lacrimal canalicular rehabilitation an office procedure. Ophthal Plast Reconstr Surg. 1990; 6:203–6.

27. Sisler HA, Allarakhia L. A new ophthalmic microtrephine. Ophthalmic Surg. 1990; 21:656–7.

28. Khoubian JF, Kikkawa DO, Gonnering RS. Trephination and silicone stent intubation for the treatment of canalicular obstruction: Effect of the level of obstruction. Ophthal Plast Resonstr Surg. 2006; 22:248–52.

29. Park BS, Jang JW, Byon DS. Treatment of common canalicular obstruction using lacrimal trephine. J Korean Ophthalmol Soc. 1998; 39:1077–81.

30. Kim YK, Oh SU, Lee HC. Silicone intubation for common canalicular obstruction in adult. J Korean Ophthalmol Soc. 2001; 42:1655–60.

31. Ra H, La TY. Bicanalicular silicone tube intubation after simple probing in common canaliculus obstruction. J Korean Ophthalmol Soc. 2004; 45:540–5.

32. Tenzel RR. Canaliculodacryocystorhinostomy. Arch Ophthalmol. 1970; 84:765.

33. Hurwitz JJ. Treatment of canalicular obstructions. Can J Ophthalmol. 1982; 17:13–6.

34. Hurwitz JJ. Computerized survey of lacrimal surgery patients. Ophthalmology. 1986; 93:14–9.

35. Doucet TW, Hurwitz JJ. Canaliculodacryocystorhinostomy in the treatment of canalicular obstruction. Arch Ophthalmol. 1982; 100:306–9.

36. Doucet TW, Hurwitz JJ. Canaliculodacryocystorhinostomy in the management of unsuccessful lacrimal surgery. Arch Ophthalmol. 1982; 100:619–21.

37. Kim YD, Lee JJ. The surgical results of dacryocystorhinostomy with internal punctoplasty for common canalicular obstruction. J Korean Ophthalmol Soc. 1996; 37:1979–83.

38. Kong BD, Kim SD. The surgical results of common canaliculo-dacryocystorhinostomy. J Korean Ophthalmol Soc. 1999; 40:2362–6.

39. Ahn Y, Oh TS. Canaliculodacryocystorhinostomy in canalicular obstruction. J Korean Ophthalmol Soc. 2000; 41:320–6.

40. Kim EA, Yun YS, Lee SH, Chung WS. Surgical effect of canaliculodacryocystorhinostomy in patients with failed conjunctivodacryocystorhinostomy. J Korean Ophthalmol Soc. 2004; 45:1627–32.

41. Nik NA, Hurwitz JJ, Sang HC. Mechanism of tear flow after dacryocystorhinostomy and Jones' tube surgery. Arch Ophthalmol. 1984; 102:1643–6.

42. Henderson JW. Management of obstructions of the lacrimal canaliculi with polyethylene tubes. Arch Ophthalmol. 1950; 44:198–203.

43. Iliff CE. A simplified dacryocystorhinostomy. Trans Am Acad Ophthalmol Otolaryngol. 1954; 58:590–2.

44. Ugurbas SH, Zilelioglu G, Sargon MF, et al. Histopathologic effect of mitomycin C on endoscopic transnasal dacryocystorhinostomy. Ophthalmic Surg Lasers. 1997; 28:300–4.

45. Kao SC, Liao CL, Tseng JH, et al. Dacryocystorhinostomy with intraoperative mitomycin C. Ophthalmology. 1997; 104:86–91.

46. Zilelioglu G, Ugurbas SH, Anadolu Y, et al. Adjunctive use of endoscopic lacrimal surgery. Br J Ophthalmol. 1998; 82:63–6.

47. Yeatts RP, Neves RB. Use of mitomycin C in repeat dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 1999; 15:19–22.

48. Lee TS, Rhee KC. The effect of mitomycin C eyedrop on prevention of internal ostium obstruction after endonasal dacryocystorhinostomy. J Korean Ophthalmol Soc. 1998; 39:1915–20.

49. Park DJ, Kwak MS. The effect mitomycin C on the success rate of endoscopic dacryocystorhinostomy. J Korean Ophthalmol Soc. 2000; 41:1674–9.

50. Lee TS, Kim JS, Kim JK. The effect of double silicone tube intubation on surgical outcome of endonasal dacryocystorhinostomy. J Korean Ophthalmol Soc. 2002; 43:2089–94.

51. You YG, Choi HS, Ryou JH, Kim SJ. The results of endoscopic canaliculocystodacryorhinostomy with two sets of silicone tube intubation in canalicular obstruction. J Korean Ophthalmol Soc. 2004; 45:882–6.

52. Anderson RL, Edwards JJ. Indications, complications and results with silicone stent. Ophthalmology. 1979; 86:1474–87.

53. Lauring L. Silicone intubation of the lacrimal system: pit-falls, problem and complicaitons. Ann Ophthalmol. 1976; 84:489–98.

54. Allen K, Berlin AJ. Dacryocystorhinostomy failure: association with nasolacrimal silicone intubation. Ophthalmic Surg. 1989; 20:486–9.

Figure 1.

The photograph of putting two probes in the left lower canaliculus.

Figure 2.

Photographs that shows scissoring motion of two probes. (A) External view. (B) Intranasal view.

Table 1.

General characteristics of patients with common canalicular obstruction who have undergone endoscopic canaliculodacryocystorhinostomy

		Double probing group	Control group	Total
Age (year)		55.6±13.2	58.8±12.0	57.2±12.6
Sex, No.	Male	6	3	9
	Female	18	20	38
Laterality, No.	Right	11	8	19
	Left	9	10	19
	Both	4	5	9
Follow up period (month)		12.9±6.6	10.9±5.1	11.9±5.9

Table 2.

Etiology of common canalicular obstruction in ou study

	Double probing group	Control group	Total
Idiopathic, No.	21	17	38
Trauma & surgery, No.	2	4	6
Infection, No.	1	1	2
Congenital, No.	0	1	1

Table 3

Comparison of success or failure rates between double probing group and control group

	Success, No. (%)	Failure, No. (%)
Double probing group	27 (96)	1 (4)
Control group	24 (86)	4 (14)

Table 4.

Comparison of absence, improvement or no change of symptom between double probing group and control group

	Absence^*, No. (%)	Improvement^†, No. (%)	No change^‡, No. (%)
Double probing group	24 (86)	3 (11)	1 (3)
Control group	17 (61)	7 (25)	4 (14)

^* Absence: absence of epiphora with patent syringing.

^† Improvement: partial relief of epiphora with patent syringing.

^‡ No change: no relief of epiphora with not patent syringing.

Table 5.

Comparison of postoperative complications between double probing group and control group

	Double probing group	Control group	Total
Granuloma	1	3	4
Membranous obstruction	1	1	2
Dacryocystitis	0	2	2
Total, No. (%)	2 (7.1)	6 (21.4)	8 (14.2)

TOOLS

Similar articles