RESUMEN
Background: Nasolacrimal duct obstruction (NLDO) is characterized by epiphora and recurrent episodes of acute dacryocystitis. Despite the temporary effect of antibiotics in the acute phase, it is primarily managed by dacryocystorhinostomy (DCR). There is a new modification of external DCR that is performed without either anterior or posterior flaps. This study aimed to compare the outcomes of flapless and single-flap external DCR in adult patients with chronic symptomatic dacryocystitis secondary to NLDO. Methods: In this retrospective, non-randomized, interventional, comparative study of patients with chronic dacryocystitis secondary to primary acquired NLDO, we compared the surgical outcomes and complication rates of flapless external DCR to those of external DCR with only anterior flap suturing. We excluded patients who declined participation and those with soft stops, nasal problems, lid margin abnormalities, lid malposition or laxity, previous lacrimal surgery, lacrimal fistula, trauma involving the lacrimal drainage system, lack of adequate follow-up, or severe septal deviation or turbinate hypertrophy. Anatomical and functional success rates were determined at the last follow-up visit and were compared. Postoperative complications were recorded and compared between groups. Results: We included 53 patients with a male-to-female ratio of 16 (30.2%) to 37 (69.8%); 25 eyes underwent flapless DCR (group 1) and 28 eyes underwent anterior flap suturing DCR (group 2). The two groups had comparable demographic characteristics (all Pâ >â 0.05). Furthermore, anatomical (92.0% in group 1 and 92.9% in group 2) and functional (84.0% in group 1 and 92.9% in group 2) success rates at final follow-up were comparable between groups (both Pâ >â 0.05). At the one-month postoperative examination, premature tube extrusion was more often reported in group 1 (12.0%) compared to group 2 (7.1%). At the two-month follow-up examination, tube extrusion was noted in 4.0% in group 1 and 0.0% in group 2, yet the difference failed to attain statistical significance (Pâ >â 0.05). Conclusions: We found that neither surgical method was superior in terms of anatomical or functional success rate at a maximum of one year after external DCR. Flapless DCR is a simple, effective, and reproducible alternative to the single anterior flap suturing technique for managing NLDO in adults with chronic dacryocystitis. However, further randomized clinical trials with larger sample sizes and longer follow-up periods are recommended before generalization can be justified.
RESUMEN
PURPOSE: To report the functional and anatomical results of bicanalicular annular stent compared to bicanalicular nasal intubation in the management of traumatic lower canalicular laceration. PATIENTS AND METHODS: A retrospective comparative, non-randomized interventional study. The study included consecutive patients suffering from traumatic lower canalicular laceration attended to ophthalmology department causality at Al Azhar University hospital Damietta branch, between December 2018 and August 2020. RESULTS: The study recruited eighty-five eyes of eighty-five patients admitted for treatment of traumatic lower canalicular laceration. In thirty-three patients, canalicular integrity was restored by bicanalicular annular stent (group 1) and in twenty five patients by bicanalicular lacrimal intubation (group 2). The affected patients were predominantly males (78.8% in the first group and 80% in the second group). Etiology of trauma was due to occupational hazards; 48.5% in the first group and 36% in the second group. Anatomical success in the first group was 93.9%, and 92% in the second group. Canalicular patency was achieved in 90.9% in the first group and in 80% in the second group. CONCLUSION: There was no statistically significant difference between bicanalicular annular stent and bicanalicular nasal intubation regarding both anatomical and functional success. Both techniques represent a successful alternative to monocanalicular stent.
