Nasolacrimal Duct Obstruction Research Articles

Evaluating the outcomes of children undergoing lacrimal surgery for congenital nasolacrimal duct obstruction with the aim of developing a patient pathway for children presenting to a tertiary paedatric service with epiphora.

Nasolacrimal duct obstruction is the most common cause of epiphora in children. Management has classically focused on probing and syringing followed by stent insertion and dacryocystorhinostomy either externally or endonasally. This study aimed to assess the effectiveness and safety of these procedures. This was a retrospective analysis of the outcomes of all patients under the age of 16 who have undergone a surgical lacrimal intervention for nasolacrimal duct obstruction under general anaesthetic over a 10-year period. Outcomes included success rates and complications. A total of 432 patients were identified. Primary probe and syringing had a success rate of 83 per cent. Primary endonasal dacryocystorhinostomy had a success rate of 71 per cent, and revision surgery had a success rate of 82 per cent. Endonasal dacryocystorhinostomy is an effective and safe technique for the treatment of epiphora, and this study has provided a suggested protocol for management of patients presenting with epiphora.

Bilateral Congenital Nasolacrimal Duct Obstruction in Williams-Beuren Syndrome.

A 23-year-old patient with Williams-Beuren syndrome presented with ocular irritation and bilateral persistent tearing. Despite probing as an infant which showed bilateral nasolacrimal duct obstruction, dacryocystorhinostomy had been avoided due to the patient's syndromic supravalvular stenosis and related anesthesia risk. As the known diminished production of elastin in Williams-Beuren syndrome causes an array of associated vascular diseases, this case report hypothesizes that the lacrimal duct becomes obstructed through a similar mechanism. This case presents the unique findings of bilateral congenital nasolacrimal duct stenosis in a Williams-Beuren syndrome patient.

Accumulation of 131Iodine in the nasolacrimal sac/duct after radioiodine therapy for papillary thyroid cancer.

SPECT/CT is a powerful tool for assessing unexpected concentrations of radioiodine resulting from benign uptake in organs with sodium-iodide symporter (NIS) expression. We report a case of accumulation of 131Iodine in the nasolacrimal sac/duct after radioiodine therapy for papillary thyroid cancer. A whole-body scan was taken 3 days after the administration of 5.5 GBq of 131Iodine. SPECT/CT images localized the focal tracer uptake in the nasolacrimal sac/duct likely due to nasolacrimal duct obstruction secondary to prior radioiodine or iodine therapies. Hybrid SPECT/CT allows precise anatomical localization and help differentiate benign mimics of disease, which can alter patient management.

The Ophthalmic Manifestations of Down Syndrome.

Down Syndrome is one of the most common chromosomal conditions in the world, affecting an estimated 1:400-1:500 births. It is a multisystem genetic disorder but has a wide range of ophthalmic findings. These include strabismus, amblyopia, accommodation defects, refractive error, eyelid abnormalities, nasolacrimal duct obstruction, nystagmus, keratoconus, cataracts, retinal abnormalities, optic nerve abnormalities, and glaucoma. These ophthalmic conditions are more prevalent in children with Down Syndrome than the general pediatric population, and without exception, early identification with thoughtful screening in this patient population can drastically improve prognosis and/or quality of life.

Changes in the meibomian glands in postmenopausal women with primary acquired nasolacrimal duct obstruction: a prospective study

BackgroundPrimary acquired nasolacrimal duct obstruction (PANDO) is frequently encountered in perimenopausal women, causing tear flow stagnation and resulting in a variety of ocular discomfort symptoms. However, little is known about the alterations in the meibomian gland in postmenopausal women with PANDO. Hence, this study investigated the changes in the meibomian gland and ocular surface in postmenopausal women with PANDO.MethodsThis prospective study included 60 eyes of 60 postmenopausal women with PANDO (PANDO group) and 30 eyes of 30 postmenopausal women without PANDO (control group). The PANDO group was further subdivided into incomplete and complete PANDO groups, based on the degree of nasolacrimal duct obstruction. The patients’ symptoms were evaluated using the ocular surface disease index questionnaire. The meibomian gland and ocular surface were assessed using the Keratograph 5 M. Other ophthalmologic examinations included the tear break-up time, corneal fluorescein staining, meibomian gland expression, and Schirmer I test. The correlations between the degree of nasolacrimal duct obstruction and other metrics were analyzed.ResultsThe loss ratio of the upper eyelid was greater in the incomplete PANDO group than in the control group (p = 0.023). Meibomian gland distortion of the upper eyelid was more severe in the control group than in the complete PANDO group (p = 0.022). The non-invasive tear meniscus height was greater, whereas the intensity of corneal fluorescein staining was lower in the PANDO group than in the control group (all p < 0.05). The degree of nasolacrimal duct obstruction was positively associated with the non-invasive tear meniscus height and ocular surface disease index scores (p < 0.001 and p < 0.001, respectively). Corneal fluorescein staining and meibomian gland distortion of the upper eyelid were negatively correlated with the degree of nasolacrimal duct obstruction (p = 0.01 and p = 0.007, respectively).ConclusionPostmenopausal women with PANDO exhibit significant morphological changes in the meibomian gland. More attention should be paid to meibomian gland loss in postmenopausal women with incomplete PANDO, as it is crucial for identifying meibomian gland impairments in patients with PANDO.

Role of Oral Tranexamic Acid in Reducing Peroperative and Postoperative Hemorrhage in External Dcr Surgery

Background: External dacryocystorhinostomy (DCR) is now a well-established, effective approach to relieve nasolacrimal duct obstruction. Per operative hemorrhage obscure the operative field during surgery.so it is difficult to carry on an uncomplicated surgery. Moreover postoperative hemorrhage has become an added problem. The objective of this study is, to evaluate the effect of oral tranexamic acid in reducing both per operative and postoperative hemorrhage in external DCR surgery. Methods: This hospital based interventional quasi experiment included 60 patients with chronic dacryocystitis at DMCH between January 2014 to June 2014.Oral formulation of tranexamic acid 500mg two capsule and tablet Vit B complex as placebo started 1 hour prior to DCR surgery and continued up to second postoperative day in intervention and control group respectively. In every case, the rate of hemorrhage was evaluated peroperatively and postoperatively. Findings: In this study, mean duration of operation was 35.98 (range 30 to 51) min in group-A and 54.13(45-75min) minutes in group-B. Perioperative mean blood loss was of 15.03 ml with a maximum blood loss of 25ml in group A and was 33.57ml with maximum blood loss of 39ml in group B. Mean postoperative bleeding was 2.55ml with maximum blood loss 5ml In group A and was 5.53ml with maximum blood loss 13ml in group B. postoperatively no bleeding was found in 24(73.33%) cases in group A and 10(40%) cases in group B. Conclusion: This study suggests that oral tranaxemic acid significantly reduces peroperative and postoperative hemorrhage and reduces duration of surgery and improves the quality of DCR surgery. J Dhaka Med Coll. 2021; 30(2) : 196-201

Medial lacrimal sac excision versus conventional H-shaped lacrimal sac opening in external dacryocystorhinostomy: a comparative cohort study

ABSTRACT Purpose The external dacryocystorhinostomy (Ex-DCR) is a reliable but surgically challenging procedure to overcome a nasolacrimal duct obstruction (NLDO). The aim of this study is to describe the outcomes of a modified technique of lacrimal sac opening and to compare it with the conventional Ex-DCR. Methods This comparative cohort study included adult patients undergoing Ex-DCR for primary acquired NLDO by or under supervision of one surgeon. Group 1 (conventional Ex-DCR including H-shaped incision, anastomosis of the anterior mucosal flap to nasal mucosal flap and resection of the posterior sac flap) was compared with Group 2 (modified Ex-DCR including excision of the medial lacrimal sac and anastomosis of remaining anterior sac flap to nasal mucosal flap). Outcome measures included the success rate (defined as complete symptom relief or patent irrigation after three months), reoperation rate, redo-free survival within five years, and occurrence of postoperative bleeding and postoperative infection. Results 138 patients were included. The success rates were 94.7% (54/57 cases) for Group 1 and 96.3% (78/81) for Group 2 (p-value = 0.658). The redo-rate was 5.3% (3/75) in Group 1 and 2.5% (2/81) in Group 2 (p = 0.331). Two-year redo-free survival probability estimates were 89.8% for Group 1 and 96.3% for Group 2, respectively. No complications occurred in Group 2, whereas in Group 1, one patient (1.8%) suffered from postoperative bleeding and one (1.8%) from postoperative infection. Conclusions This study showed that our modified Ex-DCR technique is equally efficacious compared with the conventional Ex-DCR technique in adult patients with NLDO.

408 - Dental abnormalities, sinopulmonary infections, and nasolacrimal duct obstruction associated with chromosome 1q21.1 microdeletion syndrome

408 - Dental abnormalities, sinopulmonary infections, and nasolacrimal duct obstruction associated with chromosome 1q21.1 microdeletion syndrome

Lacrimal Plasty with Dacryocystorhinostomy-Anastomosis Using Microsurgery.

In DCR, the lateral aspect of the dacryocyst and the nasal mucosa are incised, and the mucosal valves are sutured together. In DCR-A, the occluded section of the dacryocyst or nasolacrimal duct was trimmed and anastomosed by circumferential suturing through a hole in the nasal mucosa. The success rate and the requirement for postoperative therapy were compared between 21 sides of DCR patients and 11 sides of nasal DCR-A patients. DCR-A was significantly better than conventional DCR. No additional postoperative therapy was required for DCR-A. DCR-A improves symptoms of nasolacrimal duct obstruction to a greater extent than conventional DCR and does not require additional postoperative treatment.

Endonasal Dacryocystorhinostomy: Results With or Without Stenting.

Introduction This is a comparative cross-sectional study done to compare the curative outcome of endonasal dacryocystorhinostomy (DCR) done with and without a silicon stent in patients with chronic dacryocystitis due to nasolacrimal duct obstruction. Methods This study was carried out in central India, involving 60 patients who were diagnosed with chronic dacryocystitis and underwent endonasal DCR (with zero-degree and 45-degree endoscopes from Olympus, with an Olympus camera and monitor) between October 2021 and September 2022. All patients were over the age of 18, with major exclusion criteria of previous DCRand sinonasal disease. All the surgeries were done by the same senior surgeon, in which 30 patients were stented (with a Prison silicone nasolacrimal duct stent) and 30 of them were non-stented. The follow-up duration for these was 12 months after the surgery. Results The outcome was evaluated at the end of three months, six months, and 12 months for both groups (patients with and without stents) using the Chi-square test. The success rate at the end of six months was 90% with stented patients and 93.3% with non-stented patients (p-value - 0.64); at six months, it was also the same (p-value - 0.64); and at the end of 12 months, it was 80% and 76.6% (p-value - 0.71) for patients with and without a stent, respectively. The final endoscopy at the end of 12 months showed 93.3% of patients who underwent stenting had a patent rhinostomy opening, and 90% of those who were not stented had a patent opening. Conclusions Our observational comparative study showed that patients with chronic dacryocystitis who underwent endonasal DCR with and without stenting had almost similar results. There was no significant difference in the outcome. So, we concluded that generally all the patients should be considered for endonasal DCR without a stent, except in special cases like revision endonasal DCR, lacrimal gland cysts, fistulas, and patients with sinonasal pathology, in whom silicon stents can be preferred.

Overview of Epiphora Referred to Oculoplastic Surgery Clinic in Adults.

The aim of the study was to evaluate etiological and demographic characteristics of the adult patients referred to the oculoplastic surgery clinic of the tertiary care center with the complaint of epiphora. The medical records of the patients who applied to the oculoplastic surgery clinic with a complaint of epiphora between January 2014 and July 2021 were reviewed retrospectively. Etiology of epiphora, age, gender, duration of symptom, and follow-up period were evaluated. According to the etiological factors, nasolacrimal system disorders such as punctal stenosis, canalicular stenosis, canaliculitis, and acquired nasolacrimal system obstruction, respectively; the causes of epiphora were grouped as eyelid abnormalities such as entropion and ectropion, and hypersecretory tear secretion due to causes such as dry eye, allergy, and inflammation. The patients with epiphora over the age of 18 with at least 6 months of follow-up were included in the study. Patients with congenital or tumor-related nasolacrimal duct obstruction (NLDO) and epiphora due to trauma-related eyelid or canaliculi injury were not included. A total of 595 medical fields were evaluated. Epiphora was present in 747 eyes of 595 patients. Of the patients, 221 (37%) were male and 376 (63%) were female. According to etiological evaluation of frequency, 372 (62.5%, 432 eyes) patients with NLDO, 63 (10.5%, 123 eyes) patients with punctal stenosis, 44 (7.3%) patients with ectropion, 38 (6.3%) patients with entropion, 37 (6.2%, 69 eyes) patients hypersecretory causes (dry eye, allergy, inflammation, etc.), 24 (4%) patients had primary canaliculitis, and 17 (2.8%) patients had epiphora due to canalicular occlusion. Epiphora is an important complaint that may occur due to different etiologies. A detailed examination of the anterior segment, lacrimal system and eyelids, and taking a history are the most important steps in the management of the patient.

Nasolacrimal Duct Obstruction in the Patients Receiving Treatment for Cancer.

Nasolacrimal Duct Obstruction in the Patients Receiving Treatment for Cancer.

Biometric characteristics of the lacrimal passages in healthy individuals and in patients with nasolacrimal duct obstruction

The study investigates the biometric characteristics of the lacrimal passages in healthy individuals and in patients with nasolacrimal duct obstruction. The study included 81 cases of partial nasolacrimal duct obstruction and 38 cases without tear drainage insufficiency. All patients underwent computed tomography with dacryocystography. Analysis of the biometric parameters involved calculation of the length, volume, and average sectional area of the nasolacrimal duct and the nasolacrimal bony canal. The ratio R4/16l was calculated (where R is the radius of the nasolacrimal duct; l is the length of the nasolacrimal duct). The normality of values was assessed using the Shapiro-Wilk test. Intergroup differences were assessed using the Mann-Whitney test and t-statistics for independent samples. Correlation analysis was performed according to the Spearman method. ROC analysis was carried out. Differences were considered significant at p≤0.05. There were significant differences in the volume (p=0.004) and the average sectional area of the nasolacrimal duct (p=0.014), as well as in the length of the nasolacrimal canal (p=0.034). Relationships were established between the age of patients without tear drainage insufficiency and the length of the nasolacrimal canal (p=0.042); the length of the nasolacrimal canal and the volume of the nasolacrimal duct (p=0.034), as well as the volume of the nasolacrimal duct and the nasolacrimal canal in partial nasolacrimal duct obstruction (p=0.017). The AUC of the R4/16l ratio in the ROC analysis was 0.653 (p=0.007). In addition to the obvious differences, it was found that the length of the nasolacrimal bony canal significantly differed in the subjects of both study groups. We considered the tear ducts as a hydrodynamic system obeying Poiseuille's law, so we calculated the ratio R4/16l. The value of this ratio varied (p=0.016), and the ROC analysis showed high sensitivity and specificity of the criterion. This makes it possible to use this ratio as a diagnostic criterion for partial nasolacrimal duct obstruction.

Impact of COVID 19 pandemic lockdown in pediatric ophthalmology service in Kedia eye hospital, Nepal

Purpose: The Objective of the study is to know and record the effect of lockdown in the outpatient and emergency services of pediatric ophthalmology department of Kedia Eye Hospital.Method: Comparison of the children attending the Pediatric Eye Department of Kedia Eye Hospital during and before lockdown. Data of February 16 2021 to April 15 2021 was compared with April 16 2021 to June 15 2021. Collection of data was done from the Kedia Eye Hospital Outpatients and Emergency Eye Register.Results: Children below 15 years of age were enrolled in this study. Number of patients recorded from February 16 to April 15 2021 were 2030 and from April 16 to June 15 2021 were 318. Male patients attending hospital before lockdown was 51.62% and 55.47% during lockdown. Before lockdown female patient in the hospital was 55.47% and during lockdown was 44.02%. Total surgeries performed before lockdown was 94 and during lockdown was 11. Before lockdown Refractive error (43.15%) was the most common problem followed by Dry eye (16.55), vernal keratoconjunctivitis (15.41%). During lockdown Refractive Error (32.38%) was common followed by viral conjunctivitis (17.92%), Nasolacrimal duct obstruction (13.83%) and Trauma (11.63%).Conclusion: COVID -19 Lockdown reduced the number of patients and surgeries in the hospital. Trauma related eye disease, ocular infections and nasolacrimal duct obstruction increased in children during the lockdown.

Development and validation of a nomogram for predicting the need for concomitant endoscopic septoplasty during endonasal endoscopic dacryocystorhinostomy.

Simultaneous endoscopic septoplasty is often required during endonasal endoscopic dacryocystorhinostomy (En-DCR) to improve access to the lacrimal sac and potentially optimize surgical success rates. In current practice, the decision to proceed to concomitant endoscopic septoplasty during En-DCR in patients with primary acquired nasolacrimal duct obstruction (PANDO) is determined by anterior rhinoscopy and nasal endoscopic examination. However, none of these methods can be used to quantitatively assess the severity of septal deviation to determine the need for concomitant endoscopic septoplasty during En-DCR. This study was thus conducted to develop and validate a radiological prediction model based on computed tomography (CT) to predict the necessity of concomitant endoscopic septoplasty during En-DCR. Data from 225 patients with PANDO and nasal septal deviation (NSD) who had undergone unilateral En-DCR in a single center from January 2022 to June 2023 were retrospectively analyzed. Least absolute shrinkage and selection operator (LASSO) was used to select predictors for concomitant endoscopic septoplasty during En-DCR. The ultimate model was developed through the application of multivariable logistic regression and subsequently confirmed through assessment with an internal validation cohort. The final model was then visually represented using a nomogram and an online calculator. In this retrospective study of 225 eyes from 225 patients with PANDO and NSD, the training cohort included 157 eyes, and the validation cohort included 68 eyes. CT imaging characteristics including NSD angle [odds ratio (OR) 1.54; 95% confidence interval (CI): 1.32-1.87], NSD location (OR 4.49; 95% CI: 1.25-18.77), NSD direction (OR 5.38; 95% CI: 1.48-24.52), and middle nasal passage width (MNPW) at the surgical side (OR 0.61; 95% CI: 0.43-0.82) were identified as independent predictors for concomitant endoscopic septoplasty during En-DCR. A novel nomogram constructed from these CT signs showed high predictive performance. The area under the curves (AUCs) of the training set and internal validation set were 0.913 and 0.909, respectively. A CT-based radiological prediction model was created to help surgeons determine if concomitant endoscopic septoplasty is needed during En-DCR in patients with PANDO and NSD.

Computed Tomography Morphology of Affected versus Unaffected Sides in Patients with Unilateral Primary Acquired Nasolacrimal Duct Obstruction

This study aimed to describe the anatomical details of the bony nasolacrimal duct (BNLD) and adjacent nasal structures by analyzing computed tomography (CT) images, and to investigate their effects on the development of primary acquired nasolacrimal duct obstruction (PANDO). A total of 50 patients with unilateral PANDO who underwent dacryocystorhinostomy, with a mean age of 57.96 years, were included. The preoperative CT images were reviewed to measure the anteroposterior and transverse diameters of the BNLD at the entrance and exit levels, as well as the minimum transverse diameter along the tract. The sagittal CT images were analyzed to classify the shape of the bony canals into columnar, funnel, flare, and hourglass. The associated paranasal abnormalities, including nasal septum deviation (NSD), sinusitis, angle between the bony inferior turbinate and medial wall of the maxillary sinus, and mucosal thickness of the inferior turbinate, were investigated. Fifty CT images were analyzed, and all parameters measured on both sides of the BNLD were not significantly different between the PANDO and non-PANDO sides, except for the minimum transverse diameter, which was significantly smaller on the PANDO side (p = 0.002). Columnar-shaped BNLD was the most common on both sides. No significant difference was observed in the incidence of paranasal abnormalities between sides; however, deviation of the septum toward the non-PANDO side was more common (67.9%). A small minimum transverse diameter of the BNLD may be a risk factor for PANDO. The association between nasal abnormalities and PANDO was not remarkable.

The Role of Systemic Inflammation in Acquired Nasolacrimal Duct Obstruction

The Role of Systemic Inflammation in Acquired Nasolacrimal Duct Obstruction

A Comparative Study of Surgical Outcome in Endoscopic Endonasal Dacrocystorhinostomy with and without Stenting

Introduction To remove tears from people’s eyes’ – is one of the greatest challenges of lacrimal surgery. Epiphora is defined as watering eye due to inadequate drainage of normally produced tears. Dacryocystitis is the inflammation of the lacrimal drainage system which presents as acute dacryocystitis or a much commonly as chronic dacryocystitis. Other common causes of ephiphora are blepharitis, conjunctivitis, trichiasis, punctal eversion and foreign bodies. The conventional treatment for watering eyes due to Naso Lacrimal Duct (NLD) is the procedure of external dacryocystorhinostomy (DCR) which has its own limitations and disadvantages. With the introduction of high resolution endoscopes for paranasal sinuses, endoscopic endonasal DCR (EnDCR) is gaining popularity. The main advantages of the endoscopic technique are minimal morbidity, less intraoperative bleed, shorter operative time, preservation of pump function of orbicularis occuli muscle, presaccal fibers and medial canthal tendon and avoidance of cutaneous scar. In EnDCR the most common cause for failure of surgery is closure of rhinostoma and to prevent this silicone tube insertion is the most preferred method. It has also been claimed that silicone tubing would improve surgical results. But studies also indicate that silicone tubing itself results in certain problems like, foreign body sensation, increased granulation tissue leading to failure, prolapse of tube leading to injury to cornea, nasal migration of tube, fistula formation, pharyngitis and associated sinusitis &amp; recurrent nose bleed. The present study was undertaken to compare the surgical results of endoscopic endonasal DCR with and without silicone stent. Aims &amp; Objectives To compare the success rates of endonasal dacryocystorhinostomy and evaluate the presence of post-operative changes and their effect on the outcome of the surgery in endoscopic dacryocystorhinostomy with and without stenting. Material &amp; Methods This Prospective randomized comparative study was carried out amongst the patients attending department of ENT and referred cases from ophthalmology department for chronic nasolacrimal duct obstruction, both as inpatients and outpatients with complaint of chronic epiphora. 50 patients divided into two groups of 25 each fulfilling inclusion and exclusion criteria were included using convenient sampling. Participants were divided into two groups of 25 each based on randomization technique. Group 1 includes patients undergoing EnDCR with stenting and Group 2 includes patients undergoing EnDCR without stenting. Patients were assessed for post-operative complications like granulations, size of the neo ostium and patency of the neo ostium were assessed on nasal endoscopy. Data was entered in MS Excel work sheet. Data was analyzed using appropriate statistical methods. Result This study had Female predominance in both the groups. No predominance for any side was observed. No major intra operative complications were observed. Duration of surgery was more in Group I which was statistically significant. Post-operative complications are seen more in group without stenting (64.0%) than in group with stenting (56%) with no statistical difference between the two groups. Granulations had no effect on the outcome of the. On subjective assessment of symptoms 92% of patients in group I and 88% of patients in group II showed improvement of symptoms post operatively. No statistical difference had been found between the results of both the groups. On objective assessment of size of the neo ostium, no statistical difference was seen between the two groups. The size of the neo ostium had no effect on the outcome of the surgery. On objective assessment of patency of the neo ostium was observed in 92% of patients in group I and 88% patients in group II with no statistical difference between the two groups. Conclusion As success rates of the surgery with stenting and without stenting are comparable and

SİLİKON TÜP ENTÜBASYONLU EKSTERNAL DAKRİYOSİSTORİNOSTOMİ; UZUN DÖNEM SONUÇLARI

Aim: To present the long-term results of bicanalicular silicone tube intubation combined with external dacryocystorhinostomy (EDRS) in-patient with nasolacrimal duct obstruction (NLDO)&#x0D; Methods: Long-term results of 169 eyes of 169 patients who underwent external dacryocystorhinostomy between January 2010 and December 2020 in our clinic were evaluated, retrospectively. On the postoperative 1st day, 10th day, 1st month, 3rd month, 6th month, 9th month, 12th month, and last visits, the patients were evaluated. Especially on the postoperative 1st day for signs of infection, the position, tension, and placement of the silicone tube, and the presence of epiphora. Silicone tubes of the patients were removed 6 months after surgery. Surgical success; The disappearance of the patient's symptoms was evaluated as the lacrimal drainage open.&#x0D; Results: 102 of our cases were female and 67 were male. The mean age-standard error was 55,48±1,36. Our average follow-up-standard error was 47,83±2,27 months. Surgical failure occurred in two of our patients. These cases were who were severe bleeding occurred during surgery and flaps were formed with difficulty. In these cases, revision surgeries were performed with an internal approach and surgical success were achieved in both of them. In our patients, who underwent bicanalicular silicone tube intubation surgery combined with external dacryocystorhinostomy, the surgical success rate was 98,76% in the first operation and 100% in the second operation.&#x0D; Conclusions: Considering the long-term results of bicanalicular silicon tube intubation combined with dacryocystorhinostomy operations, it is the most effective surgical method with the highest success rate in nasolacrimal canal obstruction.

Global survey of lacrimal surgeons on practice of nasolacrimal duct obstruction amid COVID-19 pandemic

Global survey of lacrimal surgeons on practice of nasolacrimal duct obstruction amid COVID-19 pandemic