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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
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Iatrogenic nasolacrimal duct obstruction after adnexal intervention: An avoidable consequence
Bipasha Mukherjee1, Avriel Isaac Gudkar1, Akshay Gopinathan Nair2,3
1Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India.
Oman Journal of Ophthalmology
|December 9, 2021
Summary
Iatrogenic nasolacrimal duct obstruction (NLDO) can occur after midface surgeries. Prompt diagnosis and surgical intervention, including implant removal, are crucial for successful management of these cases.
Area of Science:
- Ophthalmology
- Maxillofacial Surgery
- Anatomy
Background:
- Nasolacrimal duct obstruction (NLDO) is a known complication of rhino-orbito-facial reconstructive surgeries.
- Previous reports on iatrogenic NLDO are isolated cases.
Purpose of the Study:
- To report the clinical profiles and management outcomes of patients with iatrogenic NLDO.
- To highlight the causes and treatment strategies for acquired NLDO post-surgery.
Main Methods:
- Retrospective analysis of case records over 5 years.
- Inclusion of seven patients with NLDO secondary to orbito-facial surgeries.
- Review of surgical history, clinical presentation, imaging, and treatment outcomes.
Main Results:
- Seven patients (6 males, 1 female; mean age 29 years) presented with epiphora post-maxillofacial surgery for trauma.
- Imaging confirmed obstruction of the nasolacrimal ducts by surgical implants in all cases.
- Five patients underwent external dacryocystorhinostomy, two had dacryocystectomy, and five required implant removal.
Conclusions:
- Surgical implants can cause iatrogenic NLDO after midface reconstruction.
- Accurate anatomical knowledge and a multidisciplinary approach are essential for prevention and management.
- Inclusion of lacrimal surgery specialists can prevent avoidable complications.
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