title: The effectiveness of simultaneous lateral tarsal strip with endonasal dacryocystorhinostomy for the treatment of nasolacrimal duct obstruction and lower lid laxity.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectiveness of simultaneous lateral tarsal strip procedure (LTS) and endonasal dacryocystorhinostomy (DCR) for the treatment of nasolacrimal duct obstruction and lower lid laxity.
  
  
  METHODS
  We conducted a retrospective, interventional study of concurrent DCR with LTS for patients with nasolacrimal duct obstruction and lower lid laxity performed between March 2009 and July 2011 by a single surgeon (S.H.B.). Patient age, sex, the results of dacryoscintigraphy, time of tube removal, follow-up duration, and cause of failed surgery were recorded. Lower eyelid laxity was evaluated by a medial distraction test.
  
  
  RESULTS
  A total of 29 eyes in 17 patients were included in the study. The mean age was 61.1 ± 11.8 years (range 41 to 81 years). The mean degree of lower lid laxity was 2.4 ± 0.5. Dacryoscintigraphy showed presac delay in 22 eyes (75.9%). The tube was removed after 11.3 ± 1.9 weeks. The primary anatomical success rate was 89.5% (27 eyes) and the functional success rate was 86.2% (25 eyes). Membranous obstructions were the cause of failed surgery in 2 patients, but both patients remained symptom free after revision surgery with a diode laser.
  
  
  CONCLUSIONS
  Concurrently performed DCR with LTS can be an effective tool for the treatment of nasolacrimal duct obstruction and lower lid laxity. It is recommended for examining lid laxity carefully using lid distraction test in patients with epiphora.
authors.affiliation: Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Hwa
authors.initials: H
authors.lastname: Lee
authors.forename: Jin-young
authors.initials: JY
authors.lastname: Hwang
authors.forename: Jung Wan
authors.initials: JW
authors.lastname: Kim
authors.forename: Minsoo
authors.initials: M
authors.lastname: Park
authors.forename: Sehyun
authors.initials: S
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003608:Dacryocystorhinostomy / Q000379:methods*; D005141:Eyelid Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery*; D012189:Retrospective Studies