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Related Experiment Video

Updated: Nov 21, 2025

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
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Proximal lacrimal obstructions: a review.

Maria Grazia Fiorino1,2, Claudia Quaranta-Leoni3, Francesco M Quaranta-Leoni1,2

  • 1Orbital and Adnexal Service, Villa Tiberia Hospital - GVM Care & Research, Rome, Italy.

Acta Ophthalmologica
|January 17, 2021
PubMed
Summary

The best surgical treatment for proximal lacrimal obstructions depends on the obstruction site. Avoid mini-invasive techniques when standard surgical treatment is more beneficial for optimal outcomes.

Keywords:
Lester Jones tubecanaliculodacryocystorhinostomyconjunctivodacryocystorhinostomyendocanalicular surgerypunctoplastyretrograde intubation dacryocystorhinostomy

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Area of Science:

  • Ophthalmology
  • Oculoplastics
  • Lacrimal Surgery

Background:

  • Proximal lacrimal obstructions encompass a range of conditions affecting the tear drainage system.
  • Accurate diagnosis of the obstruction's location is crucial for effective treatment planning.

Purpose of the Study:

  • To review and summarize the etiopathogenesis, management strategies, and treatment outcomes for proximal lacrimal obstructions.
  • To provide guidance on selecting the optimal surgical approach based on the site of obstruction.

Main Methods:

  • Comprehensive electronic database search (PubMed, MEDLINE, Google Scholar) for relevant English and translated non-English articles.
  • Review of selected articles and their cross-references, extracting data on demographics, presentation, investigations, management, complications, and outcomes.

Main Results:

  • Punctoplasty and punctal dilatation with stenting show similar efficacy for punctal stenosis.
  • Dacryocystorhinostomy with retrograde intubation is more effective for proximal than mid-canalicular obstructions.
  • Trephination and intubation are effective for mid and distal canalicular obstructions without nasolacrimal duct obstruction; canaliculo-dacryocystorhinostomy is indicated for proximal common canalicular obstruction.

Conclusions:

  • The choice of surgical intervention for proximal lacrimal obstructions should be guided by precise identification of the obstruction site.
  • Mini-invasive techniques may be less effective than standard surgical treatments in certain cases, emphasizing the need for tailored approaches.