Outcome of External Dacryocytorhinotomy Combined With Membranectomy of a Dital Canalicular Obtruction

Purpoe To invetigate the accuracy of the preoperative evaluation in identifying a membranou obtruction of the dital canaliculu and the ucce rate of an external dacryocytorhinotomy (DCR) when membranectomy of the canalicular obtruction i alo performed. Deign Retropective, interventional cae erie. Method The urgical record of the lacrimal cae operated at Moorfield Eye Hopital between January 1997 and December 1999 were reviewed. All the patient with evidence of a membranou block of the canalicular opening into the ac identified and excied during the coure of a tandard DCR procedure with ilatic intubation and a minimum follow-up period of 12 month were elected for thi tudy. The record were analyzed for preoperative evaluation with yringing and probing, urgical detail, outcome, and complication. Reult In 59 (85%) cae a functional anatomoi wa etablihed after tube removal. Additionally, 5 cae (7%) had patent ytem but required later ectropion repair and conidered ucceful. Only 4 (6%) patient needed further lacrimal urgery, and one wa referred to the ENT department for naal polyp. The ilatic tube wa removed at a mean period of 6 week (D = 4; range, 2–24 week), and the mean follow-up period wa 13 month (D = 3; range, 12–29 month). The preoperative evaluation failed to identify the membranou obtruction in 30 (43%) cae, which were correctly diagnoed intraoperatively. Concluion In our erie the anatomic ucce rate of 92% after DCR with membranectomy i comparable to the outcome of the DCR procedure. The dital canalicular membranou obtruction i an anatomic factor that may lead to urgical failure if not identified and excied.