primary acquired nasolacrimal duct obstruction
Conditions
Interventions
Two groups:a piece of medical grade cotton material soaked with normal saline applied over ostium for 3 minutes versus a piece of medical grade cotton material soaked with topical mitomycin C applied
Sponsors
Research Grants Council
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Adult >=18 years old and there is no maximum age limit; Primary acquired nasolacrimal duct obstruction (PANLDO) diagnosed by lacrimal irrigation and probing, confirmed intraoperatively after incision of lacrimal sac; Informed consent for operation, randomization and recording; Compliance to follow-up and treatment.
Exclusion criteria
Exclusion criteria: Pregnancy, lactation (contraindication for topical mitomycin C); Known allergy to mitomycin, cocaine, adrenaline, steroid, silicone material; Contraindications of endonasal DCR or inability to undergo nasal endoscopy; Acute (<3 months) or non-bacterial dacryocystitis e.g. tuberculosis, fungal or parasitic; Ipsilateral canalicular disorder e.g. obstruction, canaliculitis, canaliculocele, diverticulum; Ipsilateral recurrent NLDO or any prior lacrimal intervention except punctoplasty; Ipsilateral facial paralysis despite apparent clinical recovery; Ipsilateral conditions affecting bony nasolacrimal outflow e.g. midfacial trauma/fracture42, osteoma, fibrous dysplasia and other skull-base disorders; Ipsilateral suspected or confirmed nasolacrimal or sinoorbital neoplasm 43; Ipsilateral severe ocular surface disorders e.g. ocular cicatrical pemphigoid, chemical burns, Steven Johnson Syndrome, Toxic Epidermal Necrolysis44; Conditions affecting mucosa of the nose or nasolacrimal system e.g. rhinosinusitis, Wegeners granulomatosis, sarcoidosis45, radioactive iodide46, head & neck radiotherapy47, ipsilateral maxillectomy48, systemic chemotherapy (5-fluorouracil, docetaxel49); Ipsilateral topical antiglaucomatous or chemotherapy drops (e.g. timolol50, mitomycin C); Intraoperative false passage of Bowman probe or metal part of silicone stent; Dacryolith or intrasaccal mass.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| anatomical patency, functional patency, ostium morphologies, additional procedure(s) and trial-related complication(s); | — |
Secondary
| Measure | Time frame |
|---|---|
| To identify preoperative ( demographic ), intraoperative ( endonasal, lacrimal sac ) and postoperative ( ostial ) features associated with poor outcomes.; | — |
Countries
China
Contacts
Public ContactJanice Wong
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong
Outcome results
None listed