Dacryoendoscopic Findings of Patients with Lacrimal Drainage Obstruction Associated with Cancer Treatment
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Purpose: To compare the diagnosis and treatment outcome of lacrimal drainage obstruction of patients who underwent systemicchemotherapy (CTx) or radioactive iodine treatment (RAI) by using dacryoendoscopy and at the same time performingdacryoendoscopy-guided silicone tube insertion (STI) to treat epiphora. Methods: From July 2017 to December 2020, the medical records of 11 patients (16 eyes) were diagnosed with lacrimaldrainage obstruction after CTx or RAI and underwent dacryoendoscopy-guided STI were reviewed retrospectively. We triedto count the number of obstructive sites in total patients using slit-lamp examination and dacryoendoscopic findings. Results: A total of 11 patients, 16 eyes, were enrolled in this study. The onset of epiphora in the CTx group (3.0 ± 4.0 months)was significantly shorter than that in the RAI group (52.6 ± 36.5 months, p = 0.001). There were total 32 obstructive sitesincluding 28 obstructive sites of dacryoendoscopic findings and four sites of punctual stenosis in total 16 cases. Using dacryoendoscopy,granulation findings was dominant in RAI patients (p = 0.038) and mucus finding was frequent mostly in lacrimalsac and canaliculus. In the CTx group, mucosal edema finding was dominant (p = 0.038) and fibrotic membrane finding wasfrequent in all levels of lacrimal drainage system. Regarding the obstructive location, lacrimal sac was the most frequently obstructedsite in the two groups (p = 0.038). Conclusions: The onset of epiphora in the CTx group was significantly earlier than in the RAI group. In the CTx group, mucosaledema finding was frequent in all levels of lacrimal drainage system. In the RAI group, granulation finding was frequent mostlyin lacrimal sac and canaliculus. Since the clinical outcome was satisfactory, intervention with dacryoendoscopy-guided STIcould be a treatment of choice in patients with epiphora after CTx or RAI.
Abstract
Purpose: To compare the diagnosis and treatment outcome of lacrimal drainage obstruction of patients who underwent systemicchemotherapy (CTx) or radioactive iodine treatment (RAI) by using dacryoendoscopy and at the same time performingdacryoendoscopy-guided silicone tube insertion (STI) to treat epiphora. Methods: From July 2017 to December 2020, the medical records of 11 patients (16 eyes) were diagnosed with lacrimaldrainage obstruction after CTx or RAI and underwent dacryoendoscopy-guided STI were reviewed retrospectively. We triedto count the number of obstructive sites in total patients using slit-lamp examination and dacryoendoscopic findings. Results: A total of 11 patients, 16 eyes, were enrolled in this study. The onset of epiphora in the CTx group (3.0 ± 4.0 months)was significantly shorter than that in the RAI group (52.6 ± 36.5 months, p = 0.001). There were total 32 obstructive sitesincluding 28 obstructive sites of dacryoendoscopic findings and four sites of punctual stenosis in total 16 cases. Using dacryoendoscopy,granulation findings was dominant in RAI patients (p = 0.038) and mucus finding was frequent mostly in lacrimalsac and canaliculus. In the CTx group, mucosal edema finding was dominant (p = 0.038) and fibrotic membrane finding wasfrequent in all levels of lacrimal drainage system. Regarding the obstructive location, lacrimal sac was the most frequently obstructedsite in the two groups (p = 0.038). Conclusions: The onset of epiphora in the CTx group was significantly earlier than in the RAI group. In the CTx group, mucosaledema finding was frequent in all levels of lacrimal drainage system. In the RAI group, granulation finding was frequent mostlyin lacrimal sac and canaliculus. Since the clinical outcome was satisfactory, intervention with dacryoendoscopy-guided STIcould be a treatment of choice in patients with epiphora after CTx or RAI.
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