Korean J Ophthalmol.  2018 Dec;32(6):433-437. 10.3341/kjo.2017.0124.

Clinical Results of Anti-adhesion Adjuvants after Endonasal Dacryocystorhinostomy

• Shin HY
• Paik JS
• Yang SW

• KMID: 2427956
• DOI: http://doi.org/10.3341/kjo.2017.0124

Abstract

PURPOSE
Various absorbable anti-adhesion agents have been used to prevent postoperative synechia formation after endonasal surgery. The purpose of this study was to evaluate the anti-adhesion effects of HyFence and Mediclore after endonasal dacryocystorhinostomy (DCR) compared to a mixed solution of hyaluronic acid and sodium carboxymethylcellulose (Guardix-Sol).
METHODS
In this retrospective study, endonasal DCR and silicone tube intubation were performed on 198 eyes of 151 patients. Three different anti-adhesion adjuvants were applied to the osteotomy site in the nasal cavity after standard endonasal DCR procedures. The subjects were classified into three respective groups: group A (71 eyes, Guardix-Sol 1.5 g), group B (89 eyes, HyFence 1.5 mL), and group C (38 eyes, Mediclore 1 cc). The three groups were evaluated by asking patients about subjective symptoms and by performing lacrimal irrigation tests and endoscopic examinations.
RESULTS
There were no statistically significant differences in age, sex, timing of tube removal, or follow-up period among the three groups. There were no statistically significant differences in success rates among the three groups (p = 0.990, 91.5% [65 / 71], 92.1% [82 / 89], and 92.1% [35 / 38], respectively).
CONCLUSIONS
HyFence and Mediclore are safe and effective adjunctive modalities following endonasal DCR compared to Guardix-Sol. Therefore, these agents can be considered good alternatives to Guardix-Sol to increase the success rate of endonasal DCR in treating patients with poor prognosis.

Keyword

Anti-adhesion adjuvants; Endonasal dacryocystorhinostomy; HyFence; Mediclore

MeSH Terms

Carboxymethylcellulose Sodium
Dacryocystorhinostomy*
Follow-Up Studies
Humans
Hyaluronic Acid
Intubation
Nasal Cavity
Osteotomy
Prognosis
Retrospective Studies
Silicon
Silicones
Carboxymethylcellulose Sodium
Hyaluronic Acid
Silicon
Silicones

Figure

• 

  Fig. 1 Three different anti-adhesion adjuvants. (A) Guardix-Sol, (B) HyFence, and (C) Mediclore.

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