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A simple and evolutional approach proven to re-canalize the nasolacrimal duct obstruction
  1. Dong Chen (wzc0001{at}sina.com),
  2. Jian G E (gejian{at}mail.sysu.edu.cn),
  3. Linghua Wang (wanglinghua{at}126.com),
  4. Qianying Gao (gaoqy{at}hotmail.com),
  5. Ping M A (maping0306{at}hotmail.com),
  6. Naiyang Li (naiyangli{at}126.com),
  7. De-quan Li (dequanl{at}bcm.edu),
  8. Zhichong Wang (wzc001{at}hotmail.com)
  1. Department of E.N.T, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
  2. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzho, China
  3. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzho, China
  4. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzho, China
  5. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzho, China
  6. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzho, China
  7. Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
  8. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzho, China

    Abstract

    Aim: To evaluate a new approach of re-canalization 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 underwent 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 rats were 93.1% in 506 cases of RC-NLDO, and 91.11% in 135 cases of EX-DCR. The success rats for second surgery were achieved in 85.19% on RC-NLDO and 40.0% on EX-DCR. No major intra- or post-operative complications were observed in the RC-NLDO group. The mean operative duration was 12.5 minutes for RC-NLDO while 40.3 minutes for EX-DCR (P<0.001). 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: Our findings demonstrated that the RC-NLDO was a simple and effective approach proven to re-canalize the obstructed nasolacrimal duct with a comparable success rate to EX-DCR.

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