J Korean Ophthalmol Soc.  2009 Sep;50(9):1289-1294. 10.3341/jkos.2009.50.9.1289.

Five-year Study of 120 Endoscopic Conjunctivodacryocystorhinostomy Using Porous Polyethylene-Coated Tear Drain

• Seo IH
• Lee TS

• KMID: 2212609
• DOI: http://doi.org/10.3341/jkos.2009.50.9.1289

Abstract

PURPOSE
To evaluate the long-term surgical results of 120 endoscopic conjunctivodacryocystorhinostomy (CDCR) procedures using a porous polyethylene (MEDPOR(R)) coated tear drain (MCTD(R)). METHODS: From 2002 to 2007, 120 patients who had been treated with endoscopic CDCR using MCTD(R) were investigated for its success rates and complications. After an osteotomy was made under nasal endoscopy, a tunnel was created from the caruncle in the conjunctival sac to the nasal cavity through the newly created ostium, and then the tunnel was enlarged to allow the insertion of the MCTD(R) The length of the tube to be inserted was determined under endoscopic examination. An anchoring suture was placed at the medial canthus to both the conjunctiva and the skin using a 5-0 Vicryl suture in the fashion of a purse string suture. RESULTS: Causes of obstruction included failed dacryocystorhinostomy (DCR) (74 cases) and idiopathic obstruction (22 cases). Postoperative complications were encountered in four cases with tube loss, 21 cases with a buried tube, 8 cases of extrusion to the conjunctival side, and 11 cases with obstruction caused by conjunctival incarceration or granuloma. The postoperative success rate was 89.1%. CONCLUSIONS: The authors concluded that endoscopic CDCR using MCTD(R) is an alternative to the standard conventional method for preventing dislodgement of the tube postoperatively. However, surgeons should consider that it may be challenging to insert the MCTD(R) and that in cases requiring removal, the tube can be difficult to remove due to adhesions.

Keyword

Conjunctivodacryocystorhinostomy; MCTD; Porous polyethylene coated tear drainage tube

MeSH Terms

Conjunctiva
Dacryocystorhinostomy
Endoscopy
Granuloma
Humans
Mixed Connective Tissue Disease
Nasal Cavity
Osteotomy
Polyethylene
Polyglactin 910
Postoperative Complications
Skin
Sutures
Polyethylene
Polyglactin 910

Figure

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  Figure 1. A photograph of porous polyethylene (MEDPOR®) -coated tear drain.

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  Figure 2. Tunnel widening with a straight mosquito clamp.

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  Figure 3. Multiple placements of 2-0 silk around the neck of the tube.

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  Figure 4. Schematic drawing of Lee's purse string suture technique.

Reference

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