title: Nasolacrimal recanalization as an alternative to external dacryocystorhinostomy for treating failed nasolacrimal duct intubation.
abstract: To compare the surgical duration and clinical outcomes of nasolacrimal recanalization versus external dacryocystorhinostomy (DCR) in the treatment of failed nasolacrimal duct intubation.This is a retrospective, comparative, and interventional study. We evaluated the outcomes of 66 consecutive patients undergoing either nasolacrimal recanalization (n = 32) or DCR (n = 34) in a tertiary lacrimal disease referral center. Length of surgical duration, clinical outcomes, and rate of recurrence at 18 months postoperatively were compared.The mean surgical duration was 18.5 minutes (range, 15-25 minutes) for nasolacrimal recanalization and 48.2 minutes (range, 45-61 minutes) for DCR, respectively (P < 0.001). The rate of success was 84.4% in the recanalization group and 85.3% in the DCR group, respectively (P = 0.91). The time to recurrence was 2.6 ± 1.1 months in the recanalization group and 5.6 ± 2.1 months in the DCR group (P < 0.001). Five failed cases in each group received a secondary DCR surgery with the same resolution rate (40%). The absence of ocular discharge at baseline was a significant predictor for a successful outcome in the recanalization group (P = 0.04) but not in the DCR group (P = 0.63).Nasolacrimal recanalization is an effective, safe, and time-saving alternative to DCR for the treatment of failed nasolacrimal duct intubation. Clinicians should be cautious in patients with discharge.
authors.affiliation: Department of Ophthalmology and Visual Science, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian Department of Immunology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, China Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA Key Laboratory of Myopia, National Health and Family Planning Commission, Shanghai, China Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Jiaxu
authors.initials: J
authors.lastname: Hong
authors.forename: Tingting
authors.initials: T
authors.lastname: Qian
authors.forename: Anji
authors.initials: A
authors.lastname: Wei
authors.forename: Zhongmou
authors.initials: Z
authors.lastname: Sun
authors.forename: Dan
authors.initials: D
authors.lastname: Wu
authors.forename: Yihe
authors.initials: Y
authors.lastname: Chen
authors.forename: Anna
authors.initials: A
authors.lastname: Marmalidou
authors.forename: Yi
authors.initials: Y
authors.lastname: Lu
authors.forename: Xinghuai
authors.initials: X
authors.lastname: Sun
authors.forename: Zuguo
authors.initials: Z
authors.lastname: Liu
authors.forename: Francisco
authors.initials: F
authors.lastname: Amparo
authors.forename: Jianjiang
authors.initials: J
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003608:Dacryocystorhinostomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007440:Intubation; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery*; D061646:Operative Time; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome