The watery eye--management and results

The physiology of tear drainage has been clarified by the use of lacrimal scintillography, introduced within the last decade. During the same time, anatomical depiction of the drainage pathways has been enhanced by utilisation of refined contrast-medium radiology. The results of surgery from the Unit of Ophthalmic Plastic and Reconstructive Surgery, Sydney Eye Hospital, 1973-1977, in patients with a chronically wet eye, and evaluated preoperatively on a clinical basis only, are reviewed, and the potential benefit of X-rays and scintigrams appraised in retrospect. Of 150 wet eyes undergoing D.C.R. +/- some form of intubation, 89% achieved success with the first operation, and 7% achieved subsequent procedure. The success rates at first operation within the three groups were: DCR 92%, DCR + canalicular intubation 81%, DCR + Jones conjunctivorhinostomy tube 90%. An apparent selection error of 1.3% was elicited which accurate X-ray and scintigram conceivably could have avoided.