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Trephination for canalicular obstruction: experience in 45 eyes
Nawaaz A Nathoo1, Suryasnata Rath, Darwin Wan
1Department of Ophthalmology and Visual Sciences, University of British Columbia , Vancouver , Canada and.
Orbit (Amsterdam, Netherlands)
|July 31, 2013
Summary
Trephination effectively resolves primary or secondary canalicular obstruction, with 64% of patients avoiding further dacryocystorhinostomy (DCR) surgery after one or two procedures. This simple intervention offers a successful treatment option for blocked tear ducts.
Area of Science:
- Ophthalmology
- Oculoplastics
- Tear Drainage Surgery
Background:
- Canalicular obstruction significantly impacts vision and quality of life.
- Failed dacryocystorhinostomy (DCR) can lead to persistent or recurrent canalicular obstruction.
- Effective management of canalicular obstruction is crucial for restoring tear drainage.
Purpose of the Study:
- To evaluate the efficacy of trephination for resolving primary and secondary canalicular obstructions.
- To assess trephination as an alternative to repeat dacryocystorhinostomy (DCR) after surgical failure.
Main Methods:
- Retrospective review of 45 eyes from 43 patients undergoing trephination with Crawford tube insertion (2001-2011).
- Inclusion criteria: symptomatic primary or secondary canalicular obstruction post-failed DCR.
- Minimum follow-up of 12 months.
Main Results:
- Trephination was performed on 45 eyes, predominantly in female patients (78%) with a mean age of 61 years.
- Common canalicular obstruction was most frequent (73%).
- 64% of patients required repeat intervention, including repeat trephination or dacryocystorhinostomy (DCR); re-operation rates were similar for primary and secondary obstructions (63% vs. 69%).
- No complications were reported post-trephination.
Conclusions:
- Trephination is a simple and effective procedure for managing canalicular obstructions.
- The intervention successfully treated 64% of patients, often avoiding the need for more invasive dacryocystorhinostomy (DCR) surgery.
- Trephination offers a valuable treatment option for both primary and secondary canalicular blockages.
