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Updated: Oct 13, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Orbital lobe dacryoadenectomy for refractory epiphora: a retrospective case series
Flavia Quaranta-Leoni1, Eduardo Bianchi2, Antonella Leonardi3
1Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.
Purpose:
To evaluate epiphora and ocular surface outcomes after macroscopically complete orbital lobe dacryoadenectomy with palpebral lobe preservation in selected patients with refractory epiphora after failed or intolerable conjunctivodacryocystorhinostomy (CDCR).
Methods:
This retrospective single-center case series included 11 consecutive patients with proximal canalicular obstruction and persistent epiphora after Jones tube failure or intolerance. The primary outcome was change in Munk score at 6 months. Secondary outcomes included Schirmer I, tear film break-up time (TBUT), lower tear-meniscus height, ocular surface findings, satisfaction, reintervention and complications.
Results:
All 11 patients improved by at least two Munk grades; median Munk score decreased from 4 (interquartile range [IQR], 3.5-4.0) to 1 (IQR, 1-2; exact Wilcoxon p = .001). Mean Schirmer I decreased by 4.91 mm/5 min (95% confidence interval, 3.15-6.67; p < .001) and mean TBUT by 1.05 s (95% confidence interval, 0.63-1.46; p < .001). Eight patients (72.7%) were satisfied or very satisfied and 10 (90.9%) were at least moderately satisfied. No patient underwent further lacrimal intervention or met the defined documentation based ocular surface event.
Conclusions:
In this highly selected series, macroscopically complete orbital lobe dacryoadenectomy with palpebral lobe preservation was associated with substantial improvement in refractory epiphora after failed or intolerable CDCR. Reduced Schirmer I and TBUT support cautious patient selection and longer prospective follow-up.
