Abstract
Aims Macrodacryocystography (MDCG) has been shown to be highly sensitive in evaluating the lacrimal drainage system. We aimed to compare the results of syringing/ probing with MDCG, and with surgical findings where available. We also aimed to determine whether MDCG is advisable in addition to syringing/probing when investigating epiphora.
Methods In a retrospective study, we looked at the records of 76 consecutive patients (86 eyes) presenting with epiphora over a period of 2 years (January 1993 to December 1994). All patients underwent syringing/probing and subsequent MDCG to determine the presence and level of nasolacrimal block. The results were then compared with surgical findings where available (46 eyes, 53%).
Results Surgical findings were predicted by MDCG in 95.5% of cases but in only 54% by probing. Probing findings agreed with MDCG in only 51% of cases. The main areas of disagreement were the presence of canalicular blocks and the presence of more than one block at different levels.
Conclusion A combination of syringing/ probing and MDCG provides the most accurate pre-operative lacrimal assessment and should predict all the canalicular stenoses requiring intubation. In addition, MDCG can predict physiological duct blocks beyond canalicular blocks and thus alter surgical management.
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Irfan, S., Cassels-Brown, A. & Nelson, M. Comparison between nasolacrimal syringing/probing, macrodacryo-cystography and surgical findings in the management of epiphora. Eye 12, 197–202 (1998). https://doi.org/10.1038/eye.1998.47
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DOI: https://doi.org/10.1038/eye.1998.47
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