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Comparison between nasolacrimal syringing/probing, macrodacryo-cystography and surgical findings in the management of epiphora

Eye volume 12, pages 197–202 (1998)Cite this article

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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References

  1. Keast-Butler J, Lloyd GAS, Welham RAN . Analysis of intubation macrodacryocystography with surgical correlations. Trans Ophthalmol Soc UK 1973;93:593–6.

    Google Scholar 

  2. Rose JDG, Clayton CB . Scintigraphy and contrast radiography for epiphora. Br J Radiol 1985;58:1183–6.

    CAS  Article  Google Scholar 

  3. Lloyd GAS, Jones BR, Wehlam RAN . Intubation macrodacryocystography. Br J Ophthalmol 1972;56:600–7.

    CAS  Article  Google Scholar 

  4. Dutton JJ . Diagnostic tests and imaging techniques. In: Lindberg JV, editor. Contemporary issues in ophthalmology: lacrimal surgery. Edinburgh: Churchill Livingstone, 1988:19–48.

  5. Zappia RJ, Milder B . The fluorescein dye disappearance test. Am J Ophthalmol 1972;74:160–2.

    CAS  Article  Google Scholar 

  6. Flach A . The fluorescein appearance test for lacrimal obstruction. Ann Ophthalmol 1979;11:237–42.

    CAS  PubMed  Google Scholar 

  7. Hornblass A . A simple test for lacrimal obstruction. Arch Ophthalmol 1973;90:435–6.

    CAS  Article  Google Scholar 

  8. Welham RAN . The lacrimal drainage apparatus. In: Miller S, editor. Clinical ophthalmology. Bristol: Wright, 1987:391–411.

  9. Hanna IT, MacEven CJ, Kennedy N . Lacrimal scintigraphy in the diagnosis of epiphora. Nuclear Med Commun 1992;13:416–20.

    CAS  Article  Google Scholar 

  10. Glatt JH, Chan AC, Barret L . Evaluation of dacryocystorhinostomy failure with computed tomography and computed tomographic dacryocystography. Am J Ophthalmol 1991;112:431–6.

    CAS  Article  Google Scholar 

  11. Ewing AE . Roentgen ray demonstration of lacrimal abscess cavity. Am J Ophthalmol 1964;26:1–4.

    Google Scholar 

  12. Campbell W . The radiology of the lacrimal system. Br J Radiol 1964;37:1–26.

    CAS  Article  Google Scholar 

  13. Lloyd GAS, Welham RAN . Subtraction macrodacryocystography. Br J Radiol 1974;47:379–82.

    CAS  Article  Google Scholar 

  14. Rycroft BW . Observation on cornea-plastic surgery. Proc R Soc Med 1960;53:303–10.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Mannor GE, Millman AL . Prognostic value of pre-operative dacryocystography in endoscopic DCR. Am J Ophthalmol 1992;113:134–7.

    CAS  Article  Google Scholar 

Download references

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Affiliations

  1. Department of Ophthalmology, Leeds General Infirmary, Leeds, UK

    S Irfan & A Cassels-Brown

  2. Department of Neuroradiology, Leeds General Infirmary, Leeds, UK

    M Nelson

Authors
  1. S Irfan
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  2. A Cassels-Brown
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  3. M Nelson
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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

Keywords

  • Canalicular block
  • Dacryocystorhinostomy
  • Epiphora
  • Nasolacrimal intubation
  • Nasolacrimal syringing
  • Macrodacryocystography

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