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Ann Med Surg (Lond) 2021 May 16;65:102317. Epub 2021 Apr 16.

Ophthalmology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Background: During dacryocystorhinostomy (DCR), the lacrimal sac wall biopsy is not routinely performed in our hospital, but it is recommended if there is a suspicion of underlying disease other than preoperatively or intraoperatively chronic inflammation.

Objective: Most of patients with epiphora have different causes of nasolacrimal duct obstruction (NLDO). This study aims to examine how important routine lacrimal sac biopsy is during endoscopic DCR surgery. Read More

Nepal J Ophthalmol 2021 Jan;13(25):152-156

Lumbini Eye Institute and Research Centre, Bhairahawa, Nepal.

Introduction: Non Endoscopic endo-nasal dacryocystorhinostomy retains the benefit of an Endo-nasal approach and can be done without using an expensive video endoscope or laser system.

Case Presentation: A 22 years old female presented with epiphora and medial canthal mass in her left eye, accompanied by discharge and recurrent conjunctival congestion since childhood. Physical examination revealed loss of height of the nose with discharge in her left eye, and am immobile and non-tender mass below the level of medial canthal tendon. Read More

Nepal J Ophthalmol 2020 Jul;12(24):209-215

Bharatpur Eye Hospital, Bharatpur, Chitwan, Nepal.

Introduction: Dacryocystorhinostomy (DCR) is the commonest surgery for nasolacrimal duct obstruction. Inhibition of the scarring process within the anastomosis and rhinostomy site which has been attributed to the failure of this procedure, might improve the success rate of DCR. The objective of this study was to evaluate the outcomes of DCR with Mitomycin-C (MMC) and to compare the results of DCR with and without MMC. Read More

Orbit 2021 May 11:1-5. Epub 2021 May 11.

Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA.

A 35-year-old female with a history of chronic extensive rhinosinusitis, previously treated twice with functional endoscopic sinus surgery, presented with recurrent dacryocystitis despite prior dacryocystorhinostomy. Histopathological specimens taken at the most recent sinus surgery demonstrated a lymphocytic inflammatory reaction without evidence of angiodestruction or necrosis. Flow cytometry was normal. Read More

BMJ Case Rep 2021 May 7;14(5). Epub 2021 May 7.

Department of Ophthalmology, Addenbrooke's Hospital, Cambridge, UK.

A 35-year-old woman underwent left external dacryocystorhinostomy (DCR) following a recent bout of left acute dacryocystitis. She had a right DCR 14 years earlier. Her relatively young age of presentation prompted suspicion of secondary nasolacrimal duct obstruction and, although the left lacrimal sac appeared macroscopically normal peroperatively, a lacrimal sac biopsy was taken. Read More

Braz J Otorhinolaryngol 2021 Apr 10. Epub 2021 Apr 10.

Bandırma State Hospital, Ophthalmology Department.

Introduction: Endonasal and external dacryocystorhinostomy procedures have both been used for the treatment of post-saccular obstruction of the lacrimal system. Functional success of these surgeries depends on several factors.

Objective: To evaluate the status of the rhinostomy ostium with endonasal and external approaches in dacryocystorhinostomy operations and to determine the effect of ostium size on postoperative functional success. Read More

BMC Ophthalmol 2021 Apr 19;21(1):182. Epub 2021 Apr 19.

Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Background: To introduce a treatment option: dacryoendoscopy-assisted incision of Hasner's valve under nasoendoscopy and assess its efficacy in treating membranous congenital nasolacrimal duct obstruction (CNLDO) in children older than 1 year with history of initial probing failure.

Methods: 52 eyes of 43 children with membranous CNLDO who underwent dacryoendoscopy-assisted incision of Hasner's valve under nasoendoscopy between May 2012 and October 2020 were enrolled in this retrospective study. All participants were older than 1 year and all the eyes had gone through probing at least once but still had symptoms of epiphora and discharge. Read More

Rev Esp Anestesiol Reanim 2021 Apr 7. Epub 2021 Apr 7.

Moorfields Eye Hospital NHS Foundation Trust, Londres, Reino Unido.

Eur J Ophthalmol 2021 Apr 7:11206721211008047. Epub 2021 Apr 7.

Dr Shroff's Charity Eye Hospital, New Delhi, India.

Purpose: Sialoendoscope was used as a dacryoendoscope, high- definition images of the lacrimal drainage system (LDS) were captured and its performance in congenital nasolacrimal duct obstruction (CNLDO) is reported.

Methods: Nasal endoscopy was done as the first in all the cases using a 0°, 2.7 mm nasal endoscope (Karl Stroz Tutlingan Germany). Read More

Ophthalmic Plast Reconstr Surg 2021 Mar 24. Epub 2021 Mar 24.

Division of Ophthalmology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A. Department of Ophthalmology, Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Purpose: To analyze the clinical presentation, course, and management in a large cohort of pediatric acute dacryocystitis subjects and to examine whether hospitalization and urgent surgical intervention are indeed mandatory.

Methods: A retrospective analysis of all pediatric subjects diagnosed with dacryocystitis at the Children's Hospital of Philadelphia over a 12-year period (2009-2020).

Results: One-hundred sixty-nine pediatric acute dacryocystitis patients were included in this study. Read More

Eur Arch Otorhinolaryngol 2021 Mar 27. Epub 2021 Mar 27.

Oculoplastics Institute, Division of Ophthalmology, Tel Aviv Sourasky Medical Center Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: To describe the clinical presentation, surgical intervention and clinical outcomes of patients with a lacrimal sac diverticulum.

Methods: Retrospective chart review of all patients who underwent endonasal endoscopic dacryocystorhinostomy (DCR) in a single medical center from January 2010 to October 2020. The diagnosis of a lacrimal sac diverticulum was based upon intraoperative findings. Read More

Graefes Arch Clin Exp Ophthalmol 2021 Mar 26. Epub 2021 Mar 26.

Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Road No 2, Banjara Hills, Hyderabad, Telangana, 500034, India.

Purpose: To assess the long-term outcomes of transcanalicular laser dacryocystorhinostomy in cases of primary acquired nasolacrimal duct obstruction (PANDO).

Methods: Retrospective interventional case series was performed on all patients diagnosed with PANDO and who underwent a primary transcanalicular laser dacryocystorhinostomy from Jan 2014 to June 2016. The procedure was performed using 980 nm diode laser. Read More

Auris Nasus Larynx 2021 Mar 17. Epub 2021 Mar 17.

Hadassah Medical School, Hebrew University, Jerusalem, Israel; Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.

Objective: Despite increased risks of nasolacrimal duct obstruction (NLDO) with age, and the continuous growth of the old population proportion, data on endoscopic dacryocystorhinostomy (eDCR) among the old is lacking. This study aims to evaluate long-term eDCR efficacy and safety in the old and oldest-old population.

Methods: A retrospective case-control study of patients aged 80 ≤ (oldest-old) and 65-79 (old) compared with younger controls who underwent eDCR, between 2002 and 2017. Read More

ORL J Otorhinolaryngol Relat Spec 2021 Mar 18:1-6. Epub 2021 Mar 18.

Department of Otorhinolaryngology and Head and Neck Surgery, Humanitas Clinical and Research Hospital IRCCS, Milan, Italy.

Purpose: The aim of the study was to investigate the role of the exoscope as an assisting tool in endoscopic dacryocystorhinostomy (e-DCR).

Materials And Methods: In this observational retrospective study, the application of the VITOM® exoscope was studied in a group of 21 patients undergoing mono- or bilateral DCR. The primary endpoint was to evaluate resolution of symptoms (epiphora/dacryocystitis) at the 6-month follow-up and time for surgery. Read More

Semin Ophthalmol 2021 Mar 18:1-6. Epub 2021 Mar 18.

Department of Ophthalmology, Hospital De Braga, Braga, Portugal.

: To evaluate the success rates of transcanalicular diode laser-assisted dacryocystorhinostomy (TCL-DCR) during 3 years of follow-up and to find clinical factors that influence surgical outcomes.: Major outcomes were the anatomical success defined as a patent neo-ostium tested by irrigation and the functional success defined as a patent osteotomy with the absence of epiphora, accessed at 6-month, 1, 2, and 3-year follow-up visits. To determine which factors influence success rates, patients were divided according to gender, age, previous lacrimal surgeries, nasosinusal anatomy, energy employed, treatment with topical prostaglandin analogs, and timing of extubation. Read More

Medicine (Baltimore) 2021 Mar;100(10):e24985

Department of Ophthalmology, Osaka Medical College, Takatsuki.

Rationale: Canaliculops is a rare condition, and only 11 cases have been reported previously. We report 2 cases of canaliculops, which were successfully treated using the new recanalization technique under dacryoendoscopy followed by bicanalicular lacrimal intubation.

Patient Concerns: A 78-year-old man and a 76-year-old woman had 3- and 1-year histories of medial-upper eyelid swelling (left and right, respectively) without any inflammatory signs, history of periocular trauma, herpes infection, use of specific drugs, or ophthalmic diseases of note. Read More

Orbit 2021 Mar 16. Epub 2021 Mar 16.

Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Albany, New York, USA.

Vestn Otorinolaringol 2021 ;86(1):112-116

Research Institute of Eye Diseases, Moscow, Russia.

Recently, an increase in the number of operations on the lacrimal ducts performed by otorhinolaryngologists has been noted throughout the world. During these operations, intra- and postoperative complications may develop, which require the intervention of an ophthalmologist. A rare complication of endoscopic dacryocystorhinostomy is the development of retrobulbar hemorrhage. Read More

Vestn Otorinolaringol 2021 ;86(1):58-62

Moscow Regional Clinical Research Institute named after M.F. Vladimirsky, Moscow, Russia.

The article presents modern methods of surgical treatment of chronic dacryocystitis, a brief historical review of various options for endonasal endoscopic dacryocystorhinostomy is carried out. The method of plastic seamless formation of dacryocystostomy, which does not require intubation of the lacrimal passages and/or using of silicone stoma dilators, is described. Between 2010 and 2019 at The State Budgetary Healthcare Institution of Moscow Area Moscow regional research clinical institute . Read More

Orbit 2021 Mar 8. Epub 2021 Mar 8.

Private Practice, Ankara, Turkey.

BMC Ophthalmol 2021 Mar 5;21(1):117. Epub 2021 Mar 5.

Moorfields Eye Hospital NHS Trust, 162 City Road, London, EC1V2PD, UK.

Background: To investigate the aetiopathology of recurrent epiphora or stickiness after dacryocystorhinostomy (DCR) surgery, identifiable on dacryocystography (DCG), and to assess the success rates of secondary corrective surgeries.

Methods: Consecutive post-DCR DCG images from patients with recurrent symptoms were reviewed between 2012 and 2015.

Results: One hundred fifty-nine eyes of 137 patients were evaluated. Read More

Ophthalmic Plast Reconstr Surg 2021 Mar-Apr 01;37(2):189

Ophthalmic Plast Reconstr Surg 2021 Mar-Apr 01;37(2):189

Indian J Otolaryngol Head Neck Surg 2021 Mar 8;73(1):18-24. Epub 2020 Apr 8.

Department of ENT, Christian Medical College, Vellore, Tamil Nadu India.

Knowledge of lateral nasal wall landmarks in relation to lacrimal apparatus is essential for successful endoscopic dacryocystorhinostomy. This descriptive study of right and left sagittally sectioned ten adult cadaver head specimens was done measuring various lateral nasal wall anatomical landmarks including lacrimal apparatus with digital calipers. Maxillary line was identified in 75%, majority overlapping lacrimal sac. Read More

Semin Ophthalmol 2021 Apr 27;36(3):128-131. Epub 2021 Feb 27.

Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.

Purpose: To compare matrix metalloproteinase-9 (MMP-9) point-of-care immunoassay (InflammaDry) results before and after dacryocystorhinostomy (DCR) in patients with nasolacrimal duct (NLD) obstruction.

Methods: Thirty-eight eyes of 38 patients who were diagnosed with unilateral NLD obstruction were treated with endoscopic DCR. Treatment response was monitored using InflammaDry test, tear meniscus height was measured by slit-lamp microscopy, and tear meniscus parameters (tear meniscus height, depth, and area) were measured by anterior segment optical coherence tomography at baseline and at 1 month after surgery. Read More

Eye (Lond) 2021 Feb 26. Epub 2021 Feb 26.

Department of Ophthalmology, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK.

Background: It has been suggested that ocular antihypertensives are associated with an increased risk of nasolacrimal duct obstruction. This study aims to assess the effect of topical antihypertensive treatment on surgical outcomes for patients undergoing Dacryocystorhinostomy (DCR) with intubation.

Methods: Single centre, retrospective analysis of 170 operations carried out on 144 patients between January 2014 and January 2019. Read More

BMC Ophthalmol 2021 Feb 25;21(1):103. Epub 2021 Feb 25.

Department of Ophthalmology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.

Background: The dacryoendoscope is the only instrument that can observe the luminal side of the lacrimal passage with minimal invasiveness. It was developed to treat lacrimal passage obstructions by inserting a bicanalicular nasal stent with sheath-guided bicanalicular intubation (SG-BCI). The purpose of this study was to determine the outcomes of SG-BCI to treat lacrimal passage obstructions. Read More

PLoS One 2021 25;16(2):e0247168. Epub 2021 Feb 25.

Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Republic of Korea.

Objective: To find preoperative screening criteria for dry eye syndrome (DES) that present after successful endoscopic dacryocystorhinostomy (EDCR).

Methods: We retrospectively analyzed medical records of 110 patients who underwent EDCR for nasolacrimal duct obstruction. DES diagnostic criteria were defined as tear break-up time (TBUT) less than 10 seconds, and ocular surface disease index (OSDI) score greater than 13 points. Read More

Vestn Oftalmol 2021 ;137(1):13-20

Research Institute of Eye Diseases, Moscow, Russia.

Despite the success of dacryocystorhinostomy (DCR) in the treatment of lacrimal drainage system (LDS) obliteration and the use of medical and surgical methods to prevent its recurrence, the number of relapses reaches 37%. The main etiological factor leading to this pathology is partial (stenosis) or complete obstruction of the ostium.

Purpose: To study the effectiveness of endonasal balloon dacryoplasty in partial or complete obstruction of dacryocystorhinostomy ostium. Read More

Indian J Ophthalmol 2021 Mar;69(3):751-754

Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, Telangana, India.

Our purpose was assess the long-term efficacy of 4-mm coronary balloon catheter dacryoplasty in revision endoscopic dacryocystorhinostomy (RevEnDCR). This retrospective interventional case-series was performed for patients who underwent RevEnDCR aided by a 4-mm coronary balloon catheter (CBC) dacryoplasty. The indications for the surgery were previously failed DCRs by external or endoscopic approach where the ostium showed near total cicatrization with or without the presence of organized granuloma threatening the internal common opening (ICO). Read More