A novel technique to recanalize the nasolacrimal duct with endodiathermy bipolar probe.
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Date
2013-12
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Abstract
Aims: To evaluate a new approach for recanalization (RC) of nasolacrimal duct obstruction in the treatment
of the symptomatic nasolacrimal duct obstruction (NLDO). Materials and Methods: A prospective,
interventional, comparative study in 302 eyes of 209 patients of symptomatic nontraumatic NLDO.
Eyes with previous failed surgery were excluded. One hundred and fifty‑one eyes underwent RC
with 20 G endodiathermy bipolar probe connected to a 7 W diathermy followed by bicanalicular
intubation under direct visualization. One hundred and fifty‑one eyes underwent standard external
dacryocystorhinostomy (DCR). Follow‑up was for 24 months and evaluation was done on basis of change in
symptoms and lacrimal syringing. Data was analyzed by Chi‑square test and unpaired t‑test. P value < 0.05
was considered statistically significant. Results: Success defined as an asymptomatic patient or freely patent
syringing was 92.7% (140 eyes) in RC group and 83.44% (126 eyes) in DCR group. Success was significantly
more (P ≤ 0.01) in RC than DCR group. Surgical time was significantly less in RC than DCR (P ≤ 0.001). In
RC group, RC could not be performed in three eyes and had to be later taken up for DCR. Intubation after
RC was not achieved in four eyes; however these eyes had a patent pathway till 24 months. Twenty‑two eyes
had a premature extrusion of the tube; but the success rate in these (20 eyes) was comparable to the others
within the group (P > 0.05). Two eyes in RC and one in DCR group had complications. Conclusions: RC with
20 G endodiathermy bipolar probe is a quick, simple, and effective alternative to standard external DCR.
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Keywords
DCR, endodiathermy bipolar probe, nasolacrimal duct obstruction, recanalize
Citation
Agrawal Siddharth, Gupta Sanjiv K, Singh Vinita, Agrawal Saurabh. A novel technique to recanalize the nasolacrimal duct with endodiathermy bipolar probe. Indian Journal of Ophthalmology. 2013 Dec ; 61 (12): 718-721.