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Updated: Jun 3, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Tube-Free Conjunctivodacryostomy: A Modified Technique for Refractory Proximal Lacrimal Obstruction With an
Jiayi Zhang1, Junye Zhu1, Yunhai Tu1
1National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.
Purpose:
This study evaluates the efficacy of a modified conjunctivodacryocystorhinostomy (CDCR) technique without the use of permanent intubation for the management of refractory proximal lacrimal obstruction (RPLO) in patients with an adequately sized lacrimal sac.
Methods:
A prospective interventional case series was conducted, including 16 consecutive patients (18 eyes) with RPLO and an adequately sized lacrimal sac, recruited between January 2022 and December 2024. All patients were treated with a modified tube-free CDCR technique. Anatomical and functional success rates were assessed using lacrimal irrigation and the Munk score over a follow-up period of at least 6 months.
Results:
The mean patient age was 52.3 ± 13.6 years, with a mean follow-up of 12.4 ± 5.6 months. The anatomical patency rate was 83.3% (15/18), and the functional success rate for epiphora was 77.8% (14/18). The postoperative Munk epiphora score of 2 (range, 1-3) was significantly lower than the preoperative score of 5 (range, 4-5) (Z = -3.6; P < 0.001). Postoperative complications included granuloma formation in four cases and occasional medial canthal discharge in five cases, with no additional complications reported.
Conclusions:
Modified CDCR without tube implantation demonstrated favorable clinical outcomes in patients with RPLO and an adequately sized lacrimal sac, with high anatomical and functional success rates.
Translational Relevance:
This approach may provide an effective surgical alternative for refractory proximal lacrimal obstruction, with the potential to decrease the occurrence of complications associated with long-term tube placement.
