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

Abstract

Objective To evaluate the efficacy of trephination under lacrimal endoscopy in the treatment of relapse canalicular obstruction.Methods 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 annulal drill and silicone stent intubation.All patients were followed up for 6 months postoperatively.Results Silicone tubes were successfully removed after 3 to 5 months postoperatively in all eyes.After followed up for 6 months, the complete succful rate,as defined on a total relief of epiphoria and patent on nasolacrimal irrigation,was 69.86%(51/73).Nineteen eyes (26.03%)showed improvement,which showed slight epiphoria and were unobstructed during irrigation of lacrimal passage.Three eyes (4.11%)were failure,which still had epiphoria 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 nasolacfimal duct obstruction was lower than that of simple lower canalicular obstruction or conmmon canalicular obstruction.Conclusions 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. Key words: Endoscopy; Trephining; Lacrimal duct obstruction; Recurrence