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Original Article
Clinical science
A simple and evolutional approach proven to recanalise the nasolacrimal duct obstruction
  1. D Chen1,
  2. J Ge2,
  3. L Wang2,
  4. Q Gao2,
  5. P Ma2,
  6. N Li2,
  7. D-Q Li3,
  8. Z Wang2
  1. 1
    Department of ENT, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China
  2. 2
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, PR China
  3. 3
    Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Dr Z Wang, Zhongshan Ophthalmic Center, Sun Yat-sen University, No 54 S Xianlie Road, Guangzhou 510060, PR China; wzc001{at}hotmail.com

Abstract

Aim: To evaluate a new approach of recanalisation of nasolacrimal duct obstruction (RC-NLDO) in the treatment of the nasolacrimal duct obstruction (NLDO) and chronic dacryocystitis.

Methods: 583 patients with 641 eyes suffering from NLDO and chronic dacryocystitis were enrolled in this study. The RC-NLDO was performed in 506 eyes, with 135 eyes undergoing external dacryocystorhinostomy (EX-DCR) as controls. Patient follow-up for 54 months was evaluated by symptoms, dye disappearance test, lacrimal irrigation and digital subtraction dacryocystogram. The RC-NLDO was also performed in 12 rhesus monkeys for histopathological examination.

Results: The clinical success rates were 93.1% in 506 cases of RC-NLDO and 91.11% in 135 cases of EX-DCR. The success rates for second surgery were achieved in 85.19% on RC-NLDO and 40.0% on EX-DCR. No major intra- or postoperative complications were observed in the RC-NLDO group. The mean operative duration was 12.5 min for RC-NLDO and 40.3 min for EX-DCR (p<0.001). A pathological study in rhesus monkeys demonstrated that the RC-NLDO wounded epithelium in nasolacrimal duct healed completely within 1 month without granulation tissue formation.

Conclusion: The findings demonstrate that the RC-NLDO is a simple and effective approach proven to recanalise the obstructed nasolacrimal duct with a comparable success rate to EX-DCR.

https://doi.org/10.1136/bjo.2008.149393

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    Footnotes

    • Funding This work was supported by grant no 2007BAI07A26 (WZC) from the National Key Technologies Research and Development Program of the Eleventh Five-Year Plan.

    • Competing interests None.

    • Provenance and Peer review Not commissioned; externally peer reviewed.

    • See Editorial, p 1416

    • Ethics approval Ethics approval was provided by the Institutional Review Board (IRB)/Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University.

    • Patient consent Obtained.

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