Surgical Outcomes of Endonasal Revision Surgery for Failed DCR According to Number of Silicone Tubes

Hye Min Jeon; Dong Seob Ahn; Joo Heon Roh

doi:10.7469/JKOS.2015.56.05.651

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Jeon, Ahn, and Roh: Surgical Outcomes of Endonasal Revision Surgery for Failed DCR According to Number of Silicone Tubes

Original Article

J Korean Ophthalmol Soc 2015;56(5):651-655.

Published online: 7 September 2015

DOI: https://doi.org/10.7469/JKOS.2015.56.05.651

Surgical Outcomes of Endonasal Revision Surgery for Failed DCR According to Number of Silicone Tubes

Hye Min Jeon, MD, Dong Seob Ahn, MD, Joo Heon Roh, MD

Sungmo Eye Hospital, Busan, Korea

￭ Address reprint requests to Joo Heon Roh, MD Sungmo Eye Hospital, #409-1 Haeun-daero, Haeundae-gu, Busan 612-823, Korea Tel: 82-51-743-0775, Fax: 82-51-743-0776 E-mail: rhoahn12@gmail.com

Received 25 July 201422 October 2014 Accepted 1 April 2015

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.

초록

Purpose:

To evaluate the causes of failed dacryocystorhinostomy (DCR) and the effects of transcanalicular diode laser-assisted endonasal revision surgery according to the number of silicone tubes.

Methods:

Sixty-seven patients (70 eyes) who underwent revision surgery using transcanalicular diode laser for failed primary endonasal DCR at Sungmo Eye Hospital between March 2007 and December 2012 were studied retrospectively. The causes of failed DCR and the time of recurrence were evaluated. The revision surgeries were endoscopic removal of granuloma and membrane and synechiolysis with intubation of 1 or 2 silicone tubes. We compared the results of revision surgery with 1 silicone tube and 2 silicone tube intubations.

Results:

Recurrence occurred after a mean duration of 4.6 months following the first DCR. The causes of surgical failure were granuloma (35 eyes), membranous obstruction (23 eyes), synechia (7 eyes), and functional obstruction (5 eyes). We performed revision surgery with 1 silicone tube intubation in 45 eyes (group A) and 2 silicone tube intubations in 25 eyes (group B). The final success rates in groups A and B were 75.6% (34/45) and 84% (21/25), respectively (chi-square test, p = 0.828).

Conclusions:

Transcanalicular diode laser-assisted endonasal revision surgery with 2 silicone tubes is not recommended.

Keywords: Double silicone tube intubation, Endonasal dacryocystorhinostomy, Failed dacryocystorhinostomy, Transcanalicular diode laser-assisted revision surgery

References

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Table 1.

Comparison of baseline characteristics

	Group A^*	Group B^†	p-value^∏
Age (years)	53.6 ± 11.1	52.9 ± 11.1	0.840
Sex (n, %)
Male	7 (15.6)	7 (28.0)
Female	38 (84.4)	18 (72.0)
Right/left	21/24	12/13
Time of recurrence (months)	4.4 ± 3.0	4.9 ± 1.9	0.554
Time of silicone removal (months)	3.2 ± 1.1	1st^‡: 1.2 ± 0.3	0.721
		2nd^§: 3.1 ± 0.7
Follow-up time (months)	10.3 ± 5.3	9.8 ± 3.4	0.188

Values are presented as mean ± SD unless otherwise indicated.

^* One silicone tube intubation;

^† Two silicone tube intubation;

^‡ Time that the first silicone tube was removed;

^§ Time that the second silicone tube was removed;

^∏ Student’s t-test.

Table 2.

Causes of failed endonasal dacryocystorhinostomy

	Group A^*	Group B^†	p-value^‡
Granuloma (n, %)	25 (55.6)	10 (40.0)	0.086
Membranous scarring (n, %)	14 (31.1)	9 (36.0)	0.266
Intranasal synechiae (n, %)	3 (6.7)	4 (16.0)	0.417
Functional obstruction (n, %)	3 (6.7)	2 (8.0)	1.000
Total	45	25

^* One silicone tube intubation;

^† Two silicone tube intubation;

^‡ Chi-square test.

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