Abstract
Introduction: Epiphora is a common ophthalmologic complaint and referrals to oculoplastics and, in the presence of lower complete lacrimonasal duct obstruction, may lead to mild to severe complications, thus requiring surgery to create a new drainage path. The external dacryocystorhinostomy with silicon intubation is the surgical technique with better long-term outcomes and performed in the institutions where this study was conducted. Can be performed under either general or loco-regional anesthesia, or a combination of both. Methods: This article presents a revision of 218 consecutive cases from December 2016 to June 2021 in two specialized centers with the same standardized surgical and anesthetic technique. Results: 242 surgical prontuaries were selected, with 218 filling the inclusion criteria. 13% of the patients required additional anesthetic infusion before the beginning of the surgery; 2.7% of the patients required field anesthetic infusion during the surgery and 6.4% required supplementary sedation, thus meaning a positive outcome, as the number of patients with intraoperative complaints was low, and the overall comfort was high. During the follow up, no patient required pain medication after 24 hours. Discussion: This study points towards the feasibility of the described technique in an outpatient fashion, with low, mild and tolerable side effects associated.
Highlights
Epiphora is a common ophthalmologic complaint and referrals to oculoplastics and, in the presence of lower complete lacrimonasal duct obstruction, may lead to mild to severe complications, requiring surgery to create a new drainage path
When all the territories presented with loss of thermal sensibility, the surgery was cleared to begin. 29 (13%) patients required supplementary anesthetic volume infusion prior to clearance for surgery, but 04 (1.8%) presented with the complaint of pain or discomfort during nasolacrimal duct scarification and 2 (0.9%), during posterior wall of the lacrimal sac resection, solved with surgical field anesthetic infiltration
Every surgery was performed in a outpatient fashion and the average time needed to hospitalar discharge since the end of the procedure was 35 min. 23 patients referred mild Post-operative nausea and vomiting (PONV), responding to bromopride, 10 mg, single dose treatment
Summary
Epiphora is a common ophthalmologic complaint and referrals to oculoplastics and, in the presence of lower complete lacrimonasal duct obstruction, may lead to mild to severe complications, requiring surgery to create a new drainage path. The external dacryocystorhinostomy with silicon intubation is the surgical technique with better long-term outcomes and performed in the institutions where this study was conducted. The external dacryocystorhinostomy (ED) with silicon intubation is still the one with the best outcomes and majority of studies so far [6] [7]. This surgery can be performed under general anesthesia, loco-regional or with a combination of both techniques. The ideal technique should achieve minimum bleeding rate, hospitalization time and require minimum post-operative analgesic compsumation [8] [9]
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