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Efficacy of Endoscopic Lacrimal Duct Recanalization Using Microendoscope

Javate, Reynaldo M. M.D., F.I.C.S.*; Pamintuan, Ferdinand G. M.D.; Cruz, Raul T. Jr. M.D.*

Ophthalmic Plastic & Reconstructive Surgery: September-October 2010 - Volume 26 - Issue 5 - p 330-333
doi: 10.1097/IOP.0b013e3181c7577a
Original Articles
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Purpose: To describe a new endoscopic procedure to restore the passage of tears in an obstructed lacrimal drainage system and to compare its efficacy with the standard external dacryocystorhinostomy (SE-DCR).

Methods: Patients with complete and partial primary acquired nasolacrimal duct obstruction (PANDO) were randomly allocated to 2 treatment groups using completely randomized design. The first group was treated using endoscopic lacrimal duct recanalization (ELDR), while the second group was treated using SE-DCR. Follow-up was conducted for at least 6 months and evaluated for anatomical and functional patency. Complications were also noted for both groups.

Results: A total of 86 patients underwent ELDR, 60 of whom had complete PANDO, while 26 patients had partial PANDO. Eighty patients underwent SE-DCR; 58 had complete PANDO, and 22 had partial PANDO. The combined success rate in terms of anatomical patency for ELDR was 93.02% (95% confidence interval [CI], 0.88–98) compared with 93.75% (95% CI, 0.87–90) for SE-DCR (p = 0.85). Meanwhile, the combined success rate (functional patency) for ELDR is 84.88% (95% CI, 0.77–93) versus 90.00% (95% CI, 0.83–97) for SE-DCR (p = 0.32).

Conclusions: ELDR using microendoscope is as efficacious as SE-DCR, without its associated major complications.

Endoscopic lacrimal duct recanalization using microendoscope is effective with a high success rate comparable with standard external dacryocystorhinostomy.

*Orbital and Oculofacial Plastic Surgery Section, Department of Ophthalmology and †Department of Otolaryngology, University of Santo Tomas Hospital, University of Santo Tomas, Sampaloc, Manila, Philippines

Accepted for publication October 21, 2009.

Presented as poster and oral presentations (“The Efficacy of Endoscopic Lacrimal Duct Recanalization Using Microendoscope”) at the Annual Scientific Symposium of the ASOPRS meeting, November 15–16, 2006, Las Vegas, Nevada, U.S.A., October 21–22, 2009, San Francisco, California, U.S.A.

The authors have no financial interest in any equipment, instruments, or medications discussed in this study.

Address correspondence and reprint requests to Reynaldo M. Javate, M.D., F.I.C.S., Department of Ophthalmology, University of Santo Tomas Hospital, Suite 111, 1st Floor, UST Hospital, España, Sampaloc, University of Santo Tomas, Manila, Philippines 1008. E-mail: rmjavate_md@yahoo.com

©2010The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc.