Related Experiment Video
Updated: Jul 16, 2026
07:30
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Modified conjunctivodacryocystorhinostomy for upper lacrimal system obstruction
Robert M Schwarcz1, Seongmu Lee, Robert A Goldberg
1Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. rschwarcz@gmail.com
Archives of Facial Plastic Surgery
|March 21, 2007
Summary
A modified conjunctivodacryocystorhinostomy (CDCR) technique, preserving the caruncle, shows significantly higher success rates for resolving tearing compared to conventional CDCR. This improved method offers better functional and cosmetic outcomes for patients with upper lacrimal system obstruction.
Area of Science:
- Ophthalmology
- Oculoplastics
- Lacrimal Surgery
Background:
- Upper lacrimal system obstruction causes significant tearing and discomfort.
- Conjunctivodacryocystorhinostomy (CDCR) is a surgical option for bypassing these obstructions.
- Conventional CDCR involves a caruncular incision, potentially impacting cosmesis and function.
Purpose of the Study:
- To present a modified conjunctivodacryocystorhinostomy (CDCR) technique.
- To compare the efficacy and outcomes of modified CDCR versus conventional CDCR.
- To evaluate symptom relief, patient tolerance, and complications associated with both techniques.
Main Methods:
- Retrospective analysis of 20 CDCR procedures performed over 3 years.
- Thirteen patients underwent modified CDCR (caruncle intact); 7 underwent conventional CDCR (caruncular incision).
- Success rates (complete tearing improvement), tolerance, and complications were compared.
Main Results:
- Overall success rate was 85% (13 complete, 4 partial improvements).
- Modified CDCR achieved complete improvement in 85% (11/13) of cases, significantly higher than conventional CDCR (29%, 2/7; P = .03).
- One case of tube migration and loss occurred; otherwise, modified CDCR showed improved functional and cosmetic outcomes.
Conclusions:
- Modified CDCR, preserving the caruncle, offers superior functional and cosmetic results.
- This technique achieves partial or complete resolution of tearing in nearly 92% of cases.
- Modified CDCR represents an advancement over conventional techniques for lacrimal obstruction.
Related Concept Videos
01:28Angle Closure Glaucoma: Treatment
Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
01:25Glaucoma: Overview
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
01:23Ophthalmic Drug Delivery Systems
Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...
01:27Open Angle Glaucoma: Treatment
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...