Dacryoscintigraphy as a guide for surgery in patients with functional epiphora

Area of Science:

• Ophthalmology
• Nuclear Medicine
• Surgical Planning

Background:

• Functional epiphora presents as symptomatic tearing without external causes.
• Standard lacrimal probing and irrigation may not identify the exact cause of blockage.
• Dacryoscintigraphy (DSG) offers a non-invasive method to assess tear flow dynamics.

Purpose of the Study:

• To evaluate the utility of dacryoscintigraphy (DSG) in planning surgical interventions for functional epiphora.
• To determine if DSG-guided surgery improves outcomes compared to empirical approaches.

Main Methods:

• Retrospective analysis of 77 cases with functional epiphora undergoing DSG-guided surgery.
• Patients categorized based on DSG findings: presac (before lacrimal sac) or postsac (after lacrimal sac) delay.
• Surgical success defined by resolution or improvement of epiphora symptoms.

Main Results:

• Overall surgical success rate was 83.1% in the DSG-guided cohort.
• 100% success was achieved in the presac delay group (14 cases).
• 79.4% success was observed in the postsac delay group (63 cases), with a mean follow-up of 22 months.

Conclusions:

• Dacryoscintigraphy plays a crucial role in planning surgery for functional epiphora.
• The DSG-guided approach is particularly beneficial for presac obstructions.
• This method may offer advantages over empirical treatments for specific tear drainage abnormalities.