J Korean Ophthalmol Soc.  2011 Jul;52(7):783-787. 10.3341/jkos.2011.52.7.783.

The Effectiveness of Lacrimal Trephination for the Treatment of Canalicular Obstruction

• Lee J
• Choi JB

• KMID: 2214701
• DOI: http://doi.org/10.3341/jkos.2011.52.7.783

Abstract

PURPOSE
To determine the effectiveness of lacrimal trephination to treat canalicular obstruction.
METHODS
Silicone intubation following lacrimal trephination was performed in 38 eyes of 29 patients with epiphora due to canalicular obstruction between December 2005 and October 2009. Medical records were retrospectively reviewed and telephone interviews were performed. The severity of epiphora was graded by Munk's scale, and anatomical improvement was evaluated by postoperative probing and syringing.
RESULTS
The procedure was successful in 73.7% of the cases (grade 0 or 1), and 68.4% of the eyes had complete resolution of epiphora (grade 0). The anatomical success rate was 81.6%.
CONCLUSIONS
Lacrimal trephination is a simple and effective treatment for canalicular obstructions. Therefore, lacrimal trephination could be performed prior to attempting an invasive conjunctivodacryocystorhinostomy.

Keyword

Canalicular obstruction; Lacrimal trephine; Munk's scale; Silicone tube intubation

MeSH Terms

Eye
Humans
Interviews as Topic
Intubation
Lacrimal Apparatus Diseases
Medical Records
Retrospective Studies
Silicones
Silicones

Figure

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  Figure 1. Lacrimal trephine.

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  Figure 2. Preoperative and postoperative Munk's scale. We used a reduction of epiphora to grade 0, or 1 as the criterion for success. On average, 73.7% of eyes had substantial improvement of epiphora.

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  Figure 3. Improvement of epiphora according to the level of obstruction. We defined the improvement of epiphora as post-operative Munk's grade 0, or 1.

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  Figure 4. Anatomical improvement according to the level of obstruction.

Reference

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