Clinical study on the treatment of relapse canalicular obstruction with trephination under lacrimal endoscopy

Abstract

To evaluate the efficacy of trephination under lacrimal endoscopy in the treatment of relapse canalicular obstruction. In this retrospective cases series, 67 patients (73 eyes) with relapse canalicular obstruction were examined and treated in the Second Affiliated Hospital of Nanjing Medical University between Feb. 2007 and Feb. 2008. These patients were examined by endoscopy of the lacrimal drainage system under local anesthesia, the obstructions were treated with miniature annular drill and silicone stent intubation. All patients were followed up for 6 months postoperatively. Silicone tubes were successfully removed after 3 to 5 months postoperatively in all eyes. After followed up for 6 months, the complete successful rate, as defined on a total relief of epiphora and patent on nasolacrimal irrigation, was 69.86% (51/73). Nineteen eyes (26.03%) showed improvement, which showed slight epiphora and were unobstructed during irrigation of lacrimal passage. Three eyes (4.11%) were failure, which still had epiphora and showed reflex during nasolacrimal irrigation. The effective rate of treatment was 95.89% (70/73). The effective rate for the treatment of upper and lower canalicular obstruction combined with nasolacrimal duct obstruction was lower than that of simple lower canalicular obstruction or common canalicular obstruction. Trephination under lacrimal endoscopy is a nontraumatic and effective procedure for the treatment of relapse canalicular obstruction. It significantly improves the effective rate of treatment for canalicular obstruction.