Our study showed a high success rate for dacryoendoscopy-guided probing in CNLDO patients. The use of a dacryoendoscope allows direct visualization of the lacrimal passage and is likely to become necessary for managing CNLDO.
PurposeTo evaluate the surgical outcome of dacryocystorhinostomy (DCR) by measuring the tear meniscus, using optical coherence tomography and rebamipide ophthalmic suspension.MethodsPatients with nasolacrimal obstruction and chronic dacryocystitis who were scheduled for an endonasal DCR underwent tear meniscus examinations before and 2 months after surgery. Vertical scans of the inferior menisci were performed before and at 1, 3, 5, 7, and 10 minutes after the instillation of rebamipide ophthalmic suspension. The tear menisci areas were measured with imaging software. Ten young adults without epiphora formed the control group.ResultsAnatomical success was achieved on 22 sides of 21 patients. The patients’ postoperative tear menisci were significantly smaller than the preoperative menisci at all points during the test, and the response to volume loading in the postoperative patients was corrected to nearly that of the young, healthy adults. Nevertheless, the postoperative meniscus area tended to be larger than that of the young adults at all points.ConclusionThe reduced tear meniscus area after DCR reflected the success of the surgical procedure. However, incomplete recovery of the meniscus after the test might suggest a residual disorder of the lacrimal drainage system after DCR.
Stratospheric Platform (SPF) project is an enterprize to develop an airship to float at the altitude of 20 km for the use of earth observations and telecommunications. SPF-II is one of the steps toward realizing SPF to examine the stabilized flight of an airship at the altitude of 4 km, and is planned to be aloft in 2004. The earth observatoin facility on SPF-II will consist of three sensors: a visible-near infrared (VIS-NIR) sensor for the wavelength region 500 -1000 nm, a thermal infrared (TIR) sensor, and a trafic-monitoring sensor. In this paper, we present an outline of VIS-NIR and TIR sensors. The VIS-NIR and TIR sensors are planned as wide field (110 degree) imagers with 2-dimensional FPAs. Polarizetion will be measured with the VIS-NIR sensor.FOV of the VIS-NIR sensor is to be 8 km square at the footprint, and horizontal resolution to be 8 m with a 1280 × 1024 pixel Si-CCD FPA. The TIR sensor adopts an uncooled 320 × 240 pixel bolometer array, and has a FOV of 8 km × 6 kmsquare at the footprint, with horizontal resolution of 25 m. It covers three wavelength bands of 8.5, 10.8, and 12.0 µm with the filter wheel device.
Purpose
To evaluate clinical outcomes of patients who underwent endonasal dacryocystorhinostomy (En-DCR) and investigate prognostic factors.
Methods
We recruited 304 patients from two institutes. The tear meniscus height (TMH) was measured using anterior segment optical coherence tomography before surgery. All patients underwent endoscopic DCR with lacrimal intubation stent insertion. The lacrimal stent was removed 2 months after surgery. The TMH was measured 2 months and 12 months after surgery. Improvements in epiphora were assessed using a visual analogue scale (range, 0–2). Recurrence was determined based on lacrimal irrigation and endoscopic evaluation results.
Results
All patients experienced improvements in subjective symptoms 2 months after surgery. The mean TMH also decreased significantly compared with that before surgery. During the follow-up period, four patients experienced recurrence. The mean TMH 12 months after surgery was significantly lower than that before surgery. The rate of change in the TMH was significantly associated with the use of a dacryoendoscope during sheath-guided lacrimal stent intubation at all time points. Of the 251 patients who were followed up at 12 months after surgery, three reported recurrences, and 17 reported mild improvement of epiphora. The rate of change in the TMH was significantly associated with epiphora improvement. Height was also associated with epiphora improvement.
Conclusions
Endoscopic DCR is an acceptable surgical procedure for managing nasolacrimal duct obstruction. Sheath-guided lacrimal stent intubation using a dacryoendoscope decreases postoperative TMH more than blind insertion, which may lead to favourable clinical outcomes.
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