Trephination for Canalicular Obstruction: Experience in 45 Eyes

Nathoo, Nawaaz; Rath, Suryasnata; Wan, Darwin; Buffam, Frank V.

doi:10.3109/01676830.2013.814685

Cited by 13 publications

(8 citation statements)

References 8 publications

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“…4,5 In the only report of trephination after prior lacrimal surgery, 22 of 32 cases (69%) required further treatment. 7 This 69% revision rate contrasted with our 32% revisional rate.…”

Section: Transcanalicular Trephination For Canalicular Block After Dacryocystorhinostomycontrasting

confidence: 71%

Transcanalicular Trephination for Canalicular Block after Dacryocystorhinostomy

Vahdani

Rose

2019

Ophthalmology

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“…4,5 In the only report of trephination after prior lacrimal surgery, 22 of 32 cases (69%) required further treatment. 7 This 69% revision rate contrasted with our 32% revisional rate.…”

Section: Transcanalicular Trephination For Canalicular Block After Dacryocystorhinostomycontrasting

confidence: 71%

Transcanalicular Trephination for Canalicular Block after Dacryocystorhinostomy

Vahdani

Rose

2019

Ophthalmology

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“…Khoubian et al [ 8 ] performed canalicular trephination and silicone stent intubation for canalicular obstructions and achieved a high success rate in distal lower canalicular obstructions; however, the authors did not perform a statistical analysis. Nathoo et al [ 11 ] evaluated the efficacy of trephination for primary canalicular obstructions and determined that it was difficult to draw any conclusions regarding the success of trephination in relation to the location of the obstruction. Despite not reaching a p -value of statistical significance, the anatomical success rate in the present study was the highest for distal lower canalicular obstructions (92.8%) and lowest for upper canalicular obstructions (66.7%).…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes of Canalicular Trephination Combined with Endoscopic Dacryocystorhinostomy in Patients with Distal or Common Canalicular Obstruction

Kong

Choi

Jang

et al. 2015

Korean J Ophthalmol

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PurposeThis study investigated the surgical outcomes of canalicular trephination combined with endoscopic dacryocystorhinostomy (DCR) in patients with a distal or common canalicular obstruction. It also identified the factors affecting surgical success rates associated with this technique.MethodsWe retrospectively reviewed the medical records of 57 patients (59 eyes) in whom a canalicular obstruction was encountered during endoscopic DCR. All patients were treated with endoscopic DCR, followed by canalicular trephination and silicone tube placement. The surgical outcome was categorized as a functional success according to the patient's subjective assessment of symptoms, including epiphora, and as an anatomical success according to a postoperative nasolacrimal duct irrigation test. Surgical success rates were compared based on age, sex, location of the obstruction, number of silicone tubes, and experience of the surgeon.ResultsFunctional success was achieved in 55 of 59 eyes (93%) at one month, 50 eyes (84%) at three months, and 46 eyes (78%) at six months. Anatomical success was achieved in 58 of 59 eyes (98%) at one month, 52 eyes (88%) at three months, and 50 eyes (84%) at six months. There was a statistically significant difference in surgical outcome according to the experience of the surgeon. The anatomical success rate at the six-month follow-up exam was 95.4% in the >5 years of experience group, and 53.3% in the <5 years of experience group (p = 0.008, Pearson chi-square test).ConclusionsThe success rate of canalicular trephination combined with endoscopic DCR in patients with a distal or common canalicular obstruction decreased gradually during the six-month follow-up period. In particular, patients undergoing procedures with experienced surgeons tended to show excellent surgical outcomes at the six-month follow-up exam.

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“…According to another study, distal lower obstructions showed the highest success rate following trephination, with complete relief from functional epiphora, followed by distal bicanalicular obstructions, common canalicular and proximal obstructions (Khoubian et al 2006). A retrospective study evaluated 45 eyes, 35 having been previously submitted to DCR: functional success was achieved in 94% (complete in 50%, partial in 44%) of patients that underwent single trephination at a mean of 32.8-month followup (Nathoo et al 2013). Anatomical success was reported in 88% of patients -complete in 63%, partial in 25% -and it was concluded that trephination may be useful as an adjunctive minimally invasive office procedure in almost twothirds of patients who develop either primary canalicular obstructions or secondary obstructions following DCR (Nathoo et al 2013).…”

Section: Management Of Distal Canalicular Obstructions and Common Canalicular Obstructionsmentioning

confidence: 99%

“…A retrospective study evaluated 45 eyes, 35 having been previously submitted to DCR: functional success was achieved in 94% (complete in 50%, partial in 44%) of patients that underwent single trephination at a mean of 32.8-month followup (Nathoo et al 2013). Anatomical success was reported in 88% of patients -complete in 63%, partial in 25% -and it was concluded that trephination may be useful as an adjunctive minimally invasive office procedure in almost twothirds of patients who develop either primary canalicular obstructions or secondary obstructions following DCR (Nathoo et al 2013). Canalicular trephination can be performed easily by means of a disposable 21-gauge trephine, with a revisional rate in 32% of cases, as recently described, highlighting the advantages of this repeatable technique with respect to the more expensive laser trephination (Vahdani & Rose 2019).…”

Section: Management Of Distal Canalicular Obstructions and Common Canalicular Obstructionsmentioning

confidence: 99%

Proximal lacrimal obstructions: a review

Fiorino

Quaranta-Leoni

Quaranta‐Leoni

2021

Acta Ophthalmologica

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Purpose: The aims of the review are to summarize the aethiopathogenesis, management and outcomes of different treatments of proximal lacrimal obstructions. Methods: An electronic database (PubMed, MEDLINE and Google Scholar) search of all articles written in English and non-English language with abstract translated to English on proximal lacrimal obstructions was performed. The articles were reviewed along with their relevant cross references. Data reviewed included demographics, presentations, investigations, management, complications and outcomes. Results: Punctoplasty is as effective as punctal dilatation with monocanalicular or bicanalicular stent in case of punctal stenosis. Dacryocystorhinostomy with retrograde intubation is more effective in case of proximal canalicular obstructions than in case of mid-canalicular obstructions. Trephination and intubation is effective in both mid and distal canalicular obstructions in patients with no associated nasolacrimal duct obstruction. Canaliculodacryocystorhinostomy has a specific indication in case of proximal common canalicular obstruction. Bypass surgery is the preferred treatment if there is no residual patency, however surgical success may not match patient satisfaction. Conclusion: Optimal choice of surgical method depends on identification of the site of obstruction. Mini-invasive techniques should be avoided in cases that would only benefit from standard surgical treatment.

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Trephination for Canalicular Obstruction: Experience in 45 Eyes

Abstract: Trephination is a simple and effective intervention for canalicular obstruction that allowed 64% of patients, through one or two procedures, to avoid the morbidity of DCR.

Cited by 13 publications

References 8 publications

Transcanalicular Trephination for Canalicular Block after Dacryocystorhinostomy

Transcanalicular Trephination for Canalicular Block after Dacryocystorhinostomy

Surgical Outcomes of Canalicular Trephination Combined with Endoscopic Dacryocystorhinostomy in Patients with Distal or Common Canalicular Obstruction

Proximal lacrimal obstructions: a review

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