title: Efficacy of tightening of orbicularis oculi muscle in patients with functional nasolacrimal duct obstruction.
abstract: OBJECTIVE
  To evaluate the efficacy of tightening of lateral portion of orbicularis oculi muscle in patients with functional nasolacrimal duct obstruction (FNLDO).
  
  
  METHODS
  This is an interventional cross-section study for evaluation of effect of orbicularis oculi tightening procedure in patients with FNLDO. Patients with unexplained epiphora, open lacrimal system in syringing and evidences of lacrimal pump weakness in lacrimal scintigraphy underwent surgery. In this procedure, a stripe of preseptal and pretarsal orbicularis muscle was dissected, slightly resected and secured to the periosteum of lateral orbital rim. Each subject completed a questionnaire about the intensity of epiphora before surgery and 1, 3 and 6 months after surgery. Furthermore, fluorescein dye disappearance test (FDDT) was performed before surgery and repeated in the follow-up visits. At last visit, the pre- and post-operative data were analyzed and compared.
  
  
  RESULTS
  Fifteen eyes of 12 patients (5 males and 7 females) with the mean age of 56.7 years included in the study. Severity of epiphora and tearing effect on daily life were significantly improved following the operation. FDDT result was improved significantly after 1 month follow-up in all eyes (15 eyes), at 3 months follow-up in 80% of eyes (12 eyes) and at the end of the 6th month in 66.7% of eyes (10 eyes). Subjective and objective success rates were 87% and 80%, respectively. No significant complications or side-effects were observed.
  
  
  CONCLUSIONS
  Tightening of lateral portion of preseptal and pretarsal orbicularis muscle seems an effective, safe, and easy procedure to decrease epiphora in patients with FNLDO.
authors.affiliation: a Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Salour
authors.affiliation: a Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Keivan
authors.initials: K
authors.lastname: Khosravifard
authors.affiliation: a Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Bagheri
authors.affiliation: a Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Yalda
authors.initials: Y
authors.lastname: Abrishami
authors.affiliation: a Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Kheiri
authors.affiliation: a Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Tavakoli
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000503:physiopathology; D007767:Lacrimal Duct Obstruction / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000503:physiopathology*; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D011795:Surveys and Questionnaires
keywords: Epiphoral; functional nasolacrimal duct obstruction; orbicularis oculi muscle