Dacryocystitis, Lacrimal Apparatus Diseases
Conditions
Brief summary
For patients with chronic epiphora, Dacryocystorhinostomy is currently the gold standard treatment, with a success rate of 80-90% according to literature. Another available treatment, which is far less used, in nasolacrimal intubation, using a silicone tube. In our study, we would like to find the efficacy of nasolacrimal duct intubation, which was performed in our medical center on a few hundred patients with mild epiphora. Study hypothesis: nasolacrimal intubation in adults, with a clinically mild epiphora, is close in it's efficacy to the Dacryocystorhinostomy procedure.
Detailed description
Under normal conditions, the amount of tears excreted from lacrimal glands to the eye is equal to the amount drained through the tear duct. Epiphora in adults usually involves a blockage of the lacrimal sac or the nasolacrimal duct. Epiphora causes tearing in patients, which can be treated sympthomatically in a conservative way (antibiotic treatment, probing of the tear duct, pressure irrigation of the tear duct) or therapeutic in an invasive way. The invasive treatment includes one of the following: 1. Dacryocystorhinostomy - surgery for reconstructing an alternative path for tear drainage. 2. Nasolacrimal intubation - inserting a silicone tube through the tear duct. The tube is usually removed after 3-6 months. Currently, there are only a few reports regarding the efficacy of nasolacrimal intubation, all with a small number of research subjects. Also, these reports have stratified the patients according to the location of the tear duct blockage, and didn't take into account the severity of the blockage (ie the severity of symptoms) prior to performing the intubation. In our research, we would like to find the efficacy of nasolacrimal intubation which was performed in our medical center on a few hundred patients with mild epiphora, and to compare in with the efficacy of the Dacryocystorhinostomy - which is 80-90% according to literature.
Interventions
DEVICESilicone tube
Silicone tube which is inserted into the tear duct through the punctum in the eyelid, then passed through the tear duct till it enters the nose and secured in place using a surgical knot. The tube remains in place for 3-6 months, than take out by the surgeon.
Sponsors
Shaare Zedek Medical Center
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of mild epiphora. * Underwent nasolacrimal intubation during 01/2000 - 12/2007.
Exclusion criteria
* Purulent excretions from nasolacrimal duct on day of admission or intubation. * Nasolacrimal intubation in the past. * Dacryocystorhinostomy in the past.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Patient being completely free of tearing. | 1 year. |
Secondary
| Measure | Time frame |
|---|---|
| Following nasolacrimal intubation, did the patient need a Dacryocystorhinostomy surgery. | 1 year |
Countries
Israel
Outcome results
None listed