J Korean Ophthalmol Soc > Volume 59(11); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(11):1001-1008.
DOI: https://doi.org/10.3341/jkos.2018.59.11.1001    Published online November 15, 2018.
Comparison of Success Rates after Silicone Tube Intubation with or without Lacrimal Endoscopy for Epiphora.
Min Gyu Choi, Jeong Kyu Lee
Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea. lk1246@cau.ac.kr
눈물흘림 환자에서 눈물길미세내시경의 사용 여부에 따른 실리콘관삽입술의 성공률 비교
최민규⋅이정규
중앙대학교 의과대학 중앙대학교병원 안과학교실
Correspondence:  Jeong Kyu Lee,
Email: lk1246@cau.ac.kr
Received: 26 July 2018   • Revised: 20 August 2018   • Accepted: 21 October 2018
Abstract
PURPOSE
To compare the success rates between silicone tube intubation using a lacrimal endoscope and using a conventional nasal endoscope alone in adult patients suffering from epiphora. METHODS: We conducted a retrospective chart review of 80 eyes of 55 patients who underwent silicone tube intubation from January 2014 to June 2017. Patients were preoperatively diagnosed with syringing and dacryocystography. The silicone tube was removed 3 months after surgery and success rates were evaluated at 4 and 12 months. Success rates were analyzed by dividing the patients into two groups, according to lacrimal endoscope use. RESULTS: A lacrimal endoscope was used in 40 eyes. In the group using a lacrimal endoscope, preoperative diagnoses were partial obstruction in 26 eyes and complete obstruction in 14 eyes. In the group without lacrimal endoscope use, preoperative diagnoses were partial obstruction in 35 eyes and complete obstruction in 5 eyes (p = 0.018). The success rates at 4 and 12 months after surgery in the two groups (with and without lacrimal endoscope use) were 87.5% and 80.0% and 72.0% and 62.1% (p = 0.546 and p = 0.565), respectively. The success rates of patients with partial obstruction in the two groups were 92.3% and 82.9% at 4 months and 71.4% and 69.2% at 12 months (p = 0.448 and p = 1.000), respectively. The success rates of patients with complete obstruction in the two groups were 78.6% and 60.0% at 4 months and 72.7% and 33.3% at 12 months (p = 0.570 and p = 0.505), respectively. Site differences, the degree of obstruction, and lacrimal endoscope use had a significant impact on the success rate at 4 and 12 months (p = 0.001 and p = 0.022, respectively). CONCLUSIONS: Although silicone tube intubation using a lacrimal endoscope cannot guarantee a significant success rate, it is possible to observe the anatomical structure of the nasolacrimal pathway in real time, such that the appropriate diagnosis and treatment can be performed simultaneously. Because patients diagnosed as having a complete obstruction had a good success rate, we can extend indication of silicone tube intubation as a less invasive approach.
Key Words: Lacrimal endoscope;Nasal endoscope;Nasolacrimal duct obstruction;Silicone tube intubation


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