CDCR with buccal mucosal graft: comparative and histopathological study

Area of Science:

• Ophthalmology
• Oculoplastics
• Surgical Innovation

Background:

• Conjunctivodacryocystorhinostomy (CDCR) effectively treats epiphora but often involves frequent post-operative complications and tube replacement.
• Alternative techniques are explored to mitigate the adverse effects associated with indwelling tubes in CDCR.

Purpose of the Study:

• To evaluate the efficacy and safety of a modified CDCR technique using a Jones tube surrounded by a buccal mucosal graft.
• To compare the outcomes of this novel technique with traditional CDCR procedures.

Main Methods:

• Fourteen patients underwent CDCR with a Jones tube and buccal mucosal graft between September 1995 and March 1997.
• Results were retrospectively compared to a previous series of 22 patients who had undergone traditional CDCR.

Main Results:

• All cases achieved functional success, resolving epiphora with a mean follow-up of 13.7 months.
• While complications were reduced compared to traditional CDCR, graft degeneration was observed in biopsies, and tube removal at six months led to passage blockage in most cases.
• Two patients required reinsertion due to tube displacement, and one experienced graft extrusion.

Conclusions:

• CDCR with buccal mucosal graft appears to be a safe and effective method for epiphora treatment, with a lower incidence of complications during the tube indwelling period.
• Early tube removal at six months post-operatively is not recommended.
• Further research with larger patient cohorts and extended follow-up is necessary to validate the long-term benefits of this technique.