Outcome of External Dacryocystorhinostomy and Monocanalicular Intubation in Patients with Total Obstruction of One Canalicus
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Purpose: We sought to evaluate the outcomes of external dacryocystorhinostomy (DCR) and mono-canalicularintubation in patients with total obstruction of one canalicus. Methods: Sixteen eyes of 16 patients with nasolacrimal duct obstruction and a single canaliculus obstructionwho had undergone external DCR and monocanalicular intubation of the intact canaliculus were retrospectivelyincluded in the present study. The monocanalicular tube (Mini Monoka) was left in place for at least twomonths. Munk epiphora grading for the evaluation of epiphora and irrigation was performed both preoperativelyand at 6 months postoperatively. Results: Mean patient age was 46 ± 14.2 (range, 18 to 76) years. The inferior canaliculus was obstructed innine eyes (group A) and the superior canaliculus was obstructed in seven eyes (group B), respectively. Eighteyes had chronic dacryocystitis and two of these eyes also had a history of acute dacryocystitis attack. Meanpreoperative Munk scores were 3.89 in group A and 4.0 in group B. Ocular surface irritation occurred in oneeye in group A. Artificial eye drops were prescribed and early tube removal was not performed. Spontaneoustube dislocation was recorded in one eye in group B. No other corneal, punctal, or canalicular complicationswere found. At six months, irrigation of intact canaliculus was patent in all eyes. Mucoid discharge, conjunctivalhyperemia, and chronic conjunctivitis were also resolved. Postoperative Munk scores were 1.11 ± 0.9 in groupA and 0.86 ± 0.9 in group B. Of note, preoperative and postoperative Munk scores were significantly differentin both groups (group A, p = 0.006; group B, p = 0.017). The postoperative Munk scores were not statisticallydifferent between the two groups (p = 0.606). Conclusions: In patients with nasolacrimal duct obstruction and a total of one canaliculus obstruction, externalDCR and monocanalicular intubation of the intact canaliculus is an effective surgical option.
Abstract
Purpose: We sought to evaluate the outcomes of external dacryocystorhinostomy (DCR) and mono-canalicularintubation in patients with total obstruction of one canalicus. Methods: Sixteen eyes of 16 patients with nasolacrimal duct obstruction and a single canaliculus obstructionwho had undergone external DCR and monocanalicular intubation of the intact canaliculus were retrospectivelyincluded in the present study. The monocanalicular tube (Mini Monoka) was left in place for at least twomonths. Munk epiphora grading for the evaluation of epiphora and irrigation was performed both preoperativelyand at 6 months postoperatively. Results: Mean patient age was 46 ± 14.2 (range, 18 to 76) years. The inferior canaliculus was obstructed innine eyes (group A) and the superior canaliculus was obstructed in seven eyes (group B), respectively. Eighteyes had chronic dacryocystitis and two of these eyes also had a history of acute dacryocystitis attack. Meanpreoperative Munk scores were 3.89 in group A and 4.0 in group B. Ocular surface irritation occurred in oneeye in group A. Artificial eye drops were prescribed and early tube removal was not performed. Spontaneoustube dislocation was recorded in one eye in group B. No other corneal, punctal, or canalicular complicationswere found. At six months, irrigation of intact canaliculus was patent in all eyes. Mucoid discharge, conjunctivalhyperemia, and chronic conjunctivitis were also resolved. Postoperative Munk scores were 1.11 ± 0.9 in groupA and 0.86 ± 0.9 in group B. Of note, preoperative and postoperative Munk scores were significantly differentin both groups (group A, p = 0.006; group B, p = 0.017). The postoperative Munk scores were not statisticallydifferent between the two groups (p = 0.606). Conclusions: In patients with nasolacrimal duct obstruction and a total of one canaliculus obstruction, externalDCR and monocanalicular intubation of the intact canaliculus is an effective surgical option.
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