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Zimmermann JA, Storp JJ, Merté RL, Lahme L, Eter N. Retrospective Analysis of Bicanalicular Lacrimal Silicone Tube Intubation in Patients with Congenital Nasolacrimal Duct Obstruction: A Long-term Follow-up Study. Klin Monbl Augenheilkd 2024. [PMID: 38670121 DOI: 10.1055/a-2237-1139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Congenital nasolacrimal duct obstruction (CNLDO) is the most common cause of epiphora in the first year of life. In addition to conservative therapy, there are several invasive methods available. The aim of this retrospective study was to conduct a long-term follow-up of bicanalicular lacrimal duct intubation as the primary intervention in a large cohort of patients with CNLDO. The electronic medical records of 487 patients with CNLDO who underwent bicanalicular tube intubation were reviewed. To determine the long-term outcomes, a telephone interview was conducted. A total of 328 eyes of 235 patients were included in the study. The median average follow-up period was 6.67 (5.58 - 8.67) years. At the time of the survey, 218 patients (92.8%) were symptom free. Mean patient satisfaction with surgical outcome was 10/10. To our knowledge, this study provides the longest follow-up of the largest patient cohort in the literature consisting of patients who underwent probing with bicanalicular lacrimal silicone tube intubation as a primary intervention for CNLDO. This study showed a high long-term postoperative success rate, with high postoperative satisfaction, few complications, and a low need for reintervention.
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Affiliation(s)
| | - Jens Julian Storp
- Department of Ophthalmology, University Hospital Münster, Münster, Germany
| | | | - Larissa Lahme
- Department of Ophthalmology, University Hospital Münster, Münster, Germany
| | - Nicole Eter
- Department of Ophthalmology, University Hospital Münster, Münster, Germany
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Zimmermann JA, Esser EL, Merté RL, Danzer MF, Rosenberger F, Brücher VC, Eter N, Alnawaiseh M, Blumberg AF, Lahme L, Mihailovic N. Nasolacrimal intubation in transcanalicular endoscopic dacryoplasty: a long-term follow-up study. Sci Rep 2023; 13:7521. [PMID: 37160950 PMCID: PMC10170144 DOI: 10.1038/s41598-023-34351-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 04/27/2023] [Indexed: 05/11/2023] Open
Abstract
Nowadays, transcanalicular endoscopic dacryoplasty represents the majority of lacrimal duct surgery procedures performed in adults in specialised centers. However, there are still hardly any data available regarding the intra- and postoperative care, particularly regarding the duration of silicone tube intubation (STI). Our aim was to evaluate the relation between tube duration and recurrence of symptoms in patients who underwent transcanalicular microdrill dacryoplasty (MDP) in a long-term setting. Medical records of 576 adult patients after MDP were retrospectively reviewed. A total of 256 eyes of 191 patients could be included. The median follow-up time was 7.83 [7.08; 9.25] years. In 57.0% of the cases there was still full resolution of symptoms at the time of the survey. The median duration of the STI was 6 [3.00; 6:00] months. When distinguishing between a tube duration < 3 months and ≥ 3 months there was a significant difference in the long-term success rate (< 3 months: 38%; ≥ 3 months: 61%; p = 0.011). In conclusion, an early removal of the STI (< 3 months) after transcanalicular MDP seems to be associated with a higher incidence of recurrence of symptoms. This should be considered in the intra- and postoperative care of patients following this minimally invasive first-step procedure.
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Affiliation(s)
- Julian Alexander Zimmermann
- Department of Ophthalmology, University of Muenster Medical Center, Domagkstraße 15, 48149, Muenster, Germany
| | - Eliane Luisa Esser
- Department of Ophthalmology, University of Muenster Medical Center, Domagkstraße 15, 48149, Muenster, Germany
| | - Ralph-Laurent Merté
- Department of Ophthalmology, University of Muenster Medical Center, Domagkstraße 15, 48149, Muenster, Germany
| | - Moritz Fabian Danzer
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Friederike Rosenberger
- Department of Ophthalmology, University of Muenster Medical Center, Domagkstraße 15, 48149, Muenster, Germany
| | - Viktoria C Brücher
- Department of Ophthalmology, University of Muenster Medical Center, Domagkstraße 15, 48149, Muenster, Germany
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, Domagkstraße 15, 48149, Muenster, Germany
| | - Maged Alnawaiseh
- Department of Ophthalmology, Klinikum Bielefeld Gem. GmbH, Bielefeld, Germany
| | - Alina Friederike Blumberg
- Department of Ophthalmology, Klinikum Fulda gAG, University of Marburg, Campus Fulda, Fulda, Germany
| | - Larissa Lahme
- Department of Ophthalmology, University of Muenster Medical Center, Domagkstraße 15, 48149, Muenster, Germany
| | - Natasa Mihailovic
- Department of Ophthalmology, University of Muenster Medical Center, Domagkstraße 15, 48149, Muenster, Germany.
- Department of Ophthalmology, Klinikum Bielefeld Gem. GmbH, Bielefeld, Germany.
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Long-Term Outcomes of Canaliculotomy with Silicone Tube Intubation in the Management of Canaliculitis. J Clin Med 2022; 11:jcm11226830. [PMID: 36431305 PMCID: PMC9698917 DOI: 10.3390/jcm11226830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/31/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
As a rare and often misdiagnosed disease of the lacrimal apparatus, only limited data exist on long-term outcomes of surgical methods for the treatment of primary canaliculitis. The aim of this study was to evaluate canaliculotomy with silicone tube intubation (STI) as a surgical procedure for canaliculitis in a long-term follow-up setting. A total of 25 eyes of 25 patients with canaliculitis treated with canaliculotomy and STI at the University of Muenster Medical Center, Germany, from 2015 to 2021 were included in this study. Data analysis involved clinical symptoms, complications, duration of STI and rate of recurrence. Mean patient age was 63.7 ± 17.2 years. After a follow-up time of 3.7 ± 1.5 years, 88% of cases showed no recurrence of inflammation. The mean duration of STI was 5.8 ± 3.4 months. Complications such as post-operative hemorrhage, spread of infection, obstruction of the canaliculus or migration of the STI were not observed in any of the patients. However, tube dislocation occurred in four cases, a pyogenic granuloma in two cases and a fistula formation in one case. The management of canaliculitis by canaliculotomy with STI showed very good postoperative outcomes and low complication rates in the long-term and can therefore be considered a safe and successful surgical approach.
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Efficacy and Safety of Modified Seamless Endoscopic Dacryocystorhinostomy in Patients with Chronic Dacryocystitis. J Ophthalmol 2022; 2022:3061859. [PMID: 36419412 PMCID: PMC9678443 DOI: 10.1155/2022/3061859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/07/2022] [Accepted: 10/29/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate the efficacy and safety of a modified seamless endoscopic dacryocystorhinostomy (EN-DCR) with chronic dacryocystitis. Methods This study included 54 patients (54 eyes) with chronic dacryocystitis treated in our hospital from 2019 to 2021, including 32 patients (32 eyes) who underwent modified and 22 patients (22 eyes) who underwent routine EN-DCR. In the modified EN-DCR, the nasal cavity was filled 30 min before the operation by injection of 1 mg/ml adrenaline hydrochloride and application of ephedrine hydrochloride and nitrofurazone nasal drops. Before the operation, the lacrimal passages were rinsed with a 1 : 2 mixture of dilute methylene blue and normal saline. The “I”-shaped incision was replaced by a “C“-shaped incision near the lateral bone window. In place of suturing, a gelatin sponge was applied at the confluence of the lacrimal sac and nasal mucosa. After the end of the operation, the lacrimal sac was filled with tapered expansion sponge for 1 week. In routine EN-DCR, the nasal cavity was filled with 1 mg/ml epinephrine hydrochloride, and nitrofurazone nasal drops were provided for 5 minutes after the beginning of the operation; and a “I”-shaped incision was made in the nasal mucosa, with one stitch for each anterior and posterior flap. Operation time, intraoperative bleeding, and postoperative lacrimal duct irrigation were compared, with the curative effect evaluated after a follow-up of 6 months. Results Operation time was significantly shorter (41.3 ± 12.1 min vs. 65.4 ± 11.6 min; χ2 = 7.312, P < 0.05) and intraoperative bleeding was significantly lower (12.5 ± 5.2 ml vs. 60.3 ± 8.9 ml; χ2 = 24.883, P < 0.05) in the modified group than in the routine EN-DCR group. After follow-up for 6 months, the effective cure rate was significantly higher in the modified group than in the routine group (96.9% vs. 68.2%; χ2 = 6.383, P < 0.05). Conclusion Compared with routine EN-DCR, modified seamless EN-DCR can achieve better surgical outcomes, shorten operation time, and reduce intraoperative bleeding.
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Hoshi S, Tasaki K, Maruo K, Ueno Y, Mori H, Morikawa S, Moriya Y, Takahashi S, Hiraoka T, Oshika T. Improvement in Dacryoendoscopic Visibility after Image Processing Using Comb-Removal and Image-Sharpening Algorithms. J Clin Med 2022; 11:jcm11082073. [PMID: 35456168 PMCID: PMC9032983 DOI: 10.3390/jcm11082073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/30/2022] [Accepted: 04/05/2022] [Indexed: 02/01/2023] Open
Abstract
Recently, a minimally invasive treatment for lacrimal passage diseases was developed using dacryoendoscopy. Good visibility of the lacrimal passage is important for examination and treatment. This study aimed to investigate whether image processing can improve the dacryoendoscopic visibility using comb-removal and image-sharpening algorithms. We processed 20 dacryoendoscopic images (original images) using comb-removal and image-sharpening algorithms. Overall, 40 images (20 original and 20 post-processing) were randomly presented to the evaluators, who scored each image on a 10-point scale. The scores of the original and post-processing images were compared statistically. Additionally, in vitro experiments were performed using a test chart to examine whether image processing could improve the dacryoendoscopic visibility in a turbid fluid. The visual score (estimate ± standard error) of the images significantly improved from 3.52 ± 0.26 (original images) to 5.77 ± 0.28 (post-processing images; p < 0.001, linear mixed-effects model). The in vitro experiments revealed that the contrast and resolution of images in the turbid fluid improved after image processing. Image processing with our comb-removal and image-sharpening algorithms improved dacryoendoscopic visibility. The techniques used in this study are applicable for real-time processing and can be easily introduced in clinical practice.
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Affiliation(s)
- Sujin Hoshi
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan; (K.T.); (Y.U.); (H.M.); (S.M.); (Y.M.); (S.T.); (T.H.); (T.O.)
- Correspondence: ; Tel.: +81-298-533-148
| | - Kuniharu Tasaki
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan; (K.T.); (Y.U.); (H.M.); (S.M.); (Y.M.); (S.T.); (T.H.); (T.O.)
| | - Kazushi Maruo
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan;
| | - Yuta Ueno
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan; (K.T.); (Y.U.); (H.M.); (S.M.); (Y.M.); (S.T.); (T.H.); (T.O.)
| | - Haruhiro Mori
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan; (K.T.); (Y.U.); (H.M.); (S.M.); (Y.M.); (S.T.); (T.H.); (T.O.)
| | - Shohei Morikawa
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan; (K.T.); (Y.U.); (H.M.); (S.M.); (Y.M.); (S.T.); (T.H.); (T.O.)
| | - Yuki Moriya
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan; (K.T.); (Y.U.); (H.M.); (S.M.); (Y.M.); (S.T.); (T.H.); (T.O.)
| | - Shoko Takahashi
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan; (K.T.); (Y.U.); (H.M.); (S.M.); (Y.M.); (S.T.); (T.H.); (T.O.)
| | - Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan; (K.T.); (Y.U.); (H.M.); (S.M.); (Y.M.); (S.T.); (T.H.); (T.O.)
| | - Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan; (K.T.); (Y.U.); (H.M.); (S.M.); (Y.M.); (S.T.); (T.H.); (T.O.)
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Mihailovic N, Grenzebach UH, Eter N, Merté RL. Application Possibilities of a New Preloaded Nasolacrimal Duct Intubation System. Klin Monbl Augenheilkd 2021; 238:48-54. [PMID: 33506448 DOI: 10.1055/a-1274-0773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The LacriJet (FCI S. A. S. - France Chirurgie Instrumentation, Paris, France) represents a novel, simplified and preloaded system for monocanalicular or monocanaliculonasal nasolacrimal duct intubation. It is a further development of the Masterka and shall reduce the intubation time during the surgical procedure. The aim of the present study was to present first experiences with this system for different indications. MATERIAL AND METHODS All patients who underwent nasolacrimal duct intubation with the LacriJet at the University of Muenster Medical Center in the period from March to November 2019 were included. The postoperative outcome was evaluated 3 to 6 months later. RESULTS In total, 12 nasolacrimal duct intubations with the LacriJet were performed at our center in the above-mentioned period. The main indication for intubation was congenital nasolacrimal duct obstruction (CNLDO). In addition, intubation was performed in cases with eye lid tumors involving the nasolacrimal duct, in a case of canalicular laceration and in a case of canaliculitis. In 3 cases, there was an early dislocation or a complete loss of intubation. Of these, 2 were cases with CNLDO and the third dislocation was due to manipulation by the patient. All in all, the functional results were satisfying. SUMMARY The use of the LacriJet is highly suitable for the treatment of CNLDO, stenting in canalicular laceration or lid tumours involving the lacrimal drainage system. However, the known disadvantages of monocanalicular intubation (dislocation, early loss of intubation) also occur with this type of system and a system briefing seems useful. The LacriJet therefore represents a modern and simple method for nasolacrimal duct intubation and can be used for various indications.
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Affiliation(s)
- Natasa Mihailovic
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Deutschland
| | | | - Nicole Eter
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Deutschland
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