title: [Postoperative complications of Toti DCR (dacryocystorhinostomy. An indication for canalicular surgery].
abstract: Failures with external DCR have also been attributed to canalicular occlusion. Since 1976 we have documented all patients with surgical reconstruction of occluded canaliculi. The indication, different surgical methods of choice and functional prognosis were evaluated.
  
  
  METHODS
  From 1976 to 1997 we have treated 272 cases. The surgical technique canaliculodacryocystorhinostomy (n = 132) was performed in 45%. Thirty operations (11%) of occluded lacrimal canaliculi due to external DCR were done. The patients ranged in age from 2 to 79 years. We examined all 29 patients (10 male, 19 female) with 30 operations (1 patient was operated on in both eyes).
  
  
  RESULTS
  The surgical procedure was performed after an interval of 1 month to 24 years (average 4 years). Seven times a second external DCR was done. Special causes of canalicular obstruction were severe previous soft tissue and bone trauma (4 patients) and congenital defects (3 patients). Canaliculorhinostomy was performed 15 times, canaliculodacryocystorhinostomy 14 times and conjunctivorhinostomy once. Fifteen operations had good functional results (without any symptoms). Five patients had good irrigation, but a prolonged fluorescein dye disappearance test. There were 10 failures with complete closure of the canaliculi.
  
  
  CONCLUSIONS
  If failure with external DCR is caused by canalicular occlusion, the microsurgical technique has a possible success rate for long-term results of about 50%. Before hand, however, all prophylactic measures have to be taken to avoid this postoperative failure.
authors.affiliation: Klinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg.
authors.forename: H G
authors.initials: HG
authors.lastname: Struck
authors.forename: F
authors.initials: F
authors.lastname: Tost
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D003608:Dacryocystorhinostomy / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D012086:Reoperation; D016896:Treatment Outcome