Evaluation of the Canalicular Entrance Into the Lacrimal Sac: An Anatomical Study

Zoumalan, Christopher I.; Joseph, Jeffrey M.; Lelli, Gary Joseph; Segal, Kira L.; Adeleye, Amanda; Kazim, Michael; Lisman, Richard D.

doi:10.1097/iop.0b013e31820d1f7b

Cited by 39 publications

(27 citation statements)

References 23 publications

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“…Therefore, based on the anatomical study by Orhan et al, the present study used the diameter at 3 mm from the dome of the lacrimal sac to determine the area of the upper portion of the lacrimal sac and the diameter at 7 mm from the dome to determine the area of the lower portion of the lacrimal sac. Many researchers have reported [18][19][20] that mucosal folds exist at the canalicular entrance of the lacrimal sac and that these mucosal folds can open and close when the eyelid opens or closes. Using a high-definition video camera, Kakizaki et al [21] observed the changes in the internal canalicular orifice along with opening and closure of the eyelid after dacryocystorhinostomy.…”

Section: Discussionmentioning

confidence: 99%

A Study of the impact of Eyelid Opening and Closing on the Volume and Morphology of the Lacrimal Sac

Wu¹,

Yunhai.Thinks²,

Chen³

et al. 2018

J Eye Dis Disord

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To study the impact of eyelid opening and closing on the volume and morphology of the lacrimal sac using computed tomography (CT) dacryocystography. Method: All of the patients underwent CT dacryocystography. After the contrast agents was injected into a patient's lacrimal sac, the orbit was first scanned with the eye open. And then the patient was told to close the eye firmly for a second scan of the orbit. The volume of the lacrimal sac was calculated by the image processing program which came with the CT machine. At the same time, the anteroposterior and transverse diameters of the lacrimal sac at 3 mm and 7 mm from the top of the lacrimal sac were measured. Results: 14 patients (14 eyes) who met the inclusion criteria were collected between December 2015 and January 2016. The average volume of the lacrimal sac obtained from the calculation based on CT dacryocystography was 0.165 ± 0.073 cm 2 when the eyelid was open and 0.165 ± 0.076 cm 2 when the eyelid was closed, there is no statistical difference. When the eyelid was open or closed, except for the anteroposterior diameter at the upper portion of the lacrimal sac, the differences in the transverse and anteroposterior diameters at the two positions of the lacrimal sac were no statistical difference. Conclusion: When the eyelid is opened or closed, there is no significant change in the lacrimal sac volume or morphology.

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Section: Discussionmentioning

confidence: 99%

A Study of the impact of Eyelid Opening and Closing on the Volume and Morphology of the Lacrimal Sac

Wu¹,

Yunhai.Thinks²,

Chen³

et al. 2018

J Eye Dis Disord

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“…9 Management of common canalicular obstruction poses unusual problems and has largely been unsatisfactory. 4,11 The conjunctivo-DCR, consisting of Jones tube placement, 5 is a bypass surgery that is standard for irreparable proximal lacrimal obstruction. 10 The success rate of this procedure varies from 75% to 80%, and results may not be universal.…”

Section: Discussionmentioning

confidence: 99%

“…In our case series, such an obstruction was diagnosed preoperatively in all cases, and therefore, we anticipated the presence of thick membranous obstruction. 11 Chronic inflammation can result in fibrosis and adherence of this valve to the mucosa resulting in obstruction at distal common canaliculus. 11 Chronic inflammation can result in fibrosis and adherence of this valve to the mucosa resulting in obstruction at distal common canaliculus.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Success of Modified External Dacryocystorhinostomy for the Treatment of Distal Common Canalicular Block

Kumar

Dulgach²,

Kamal³

et al. 2013

Asia-Pacific Journal of Ophthalmology

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“…The tip of the probe may get caught within the mucosal folds of the CIO or lacrimal sac mucosa, falsely suggesting an obstruction, an issue noted by others. 23,24 However, gentle redirection of the probe under direct visualization of the CIO and adequate lateral traction of the eyelid will generally obviate this problem. Although DCG and DSG are not routinely used in the setting of CCO, we employed these tests in addition to clinical diagnostic techniques to ensure the inclusion of only true CCO in this prospective study.…”

Section: Discussionmentioning

confidence: 99%

“…Transcanalicular techniques to address CCO have a low morbidity and limited invasiveness, therefore the need for a DCR may be questioned when the pathology is proximal to the lacrimal sac. However, direct visualization of the CIO allows one to distinguish mucosal folds more reliably from true membranes, 23 and helps to avoid misdirection of the lacrimal probe or engagement of common canalicular or distal canalicular walls. Open lacrimal techniques allow more precise guidance of the trephine or lacrimal probe to emerge at the CIO, reducing the risk of creating a false passage.…”

Section: Discussionmentioning

confidence: 99%

A prospective outcome study of membranous and solid distal common canalicular obstructions

Shams

Pirbhai

Selva

2016

Eye

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Purpose To prospectively evaluate the surgical outcomes of membranous and solid distal common canalicular obstructions (CCOs) following endoscopic dacryocystorhinostomy (EnDCR) and lacrimal intubation combined with either membranotomy or trephination. Methods This was a prospective, nonrandomized, consecutive interventional case series. Inclusion criteria included patients undergoing EnDCR with evidence of a membranous block or more solid obstruction of the distal common canaliculus, treated with membranotomy or canalicular trephination. Complete CCO was confirmed pre-operatively using dacryocystography and dacryoscintigraphy. All patients received bicanalicular intubation for 3 months with a minimum follow-up of 12 months. Functional and anatomical success was assessed at 4 weeks, 3 months, and 12 months following surgery. Functional success was defined as subjective improvement of epiphora and anatomical success as the presence of a patent ostium and a positive dye test on nasal endoscopy. Results Twenty-nine patients were included in the study with a mean age of 58 years. Twentyone patients (72%) received a membranotomy and eight (28%) required trephination. At 12 months, the functional and anatomical success rate in the membranotomy group was 90% (19/21) and 100% (21/21), respectively, and in trephination group the functional and anatomical success rate was 63% (5/8). There were no intraoperative or lacrimal stent-related complications. Conclusions Identifying and excising distal CCOs in association with EnDCR and lacrimal intubation is associated with a high degree of functional (83%) and anatomical (90%) success. The success of membranous obstructions appear be superior to outcomes for solid obstructions of the distal common canaliculus that require trephination.

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Evaluation of the Canalicular Entrance Into the Lacrimal Sac: An Anatomical Study

Cited by 39 publications

References 23 publications

A Study of the impact of Eyelid Opening and Closing on the Volume and Morphology of the Lacrimal Sac

A Study of the impact of Eyelid Opening and Closing on the Volume and Morphology of the Lacrimal Sac

Long-Term Success of Modified External Dacryocystorhinostomy for the Treatment of Distal Common Canalicular Block

A prospective outcome study of membranous and solid distal common canalicular obstructions

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