Abstract
Objective
1) Comparing 4 methods when doing a DCR. 2) Determining superiority of stenting versus fistulization.
Methods
Randomized uncontrolled study. 12 years (1994 to 2007), chronic dacryocytitis, 1195 patients studied, primary health care. 1. Resolution of Epiphora 2. Patency 3. Complete resolution of abcess Endoscopic DCR. 4 methods: simple incision, grommet insertion, stenting, and fistulization. 255 patients had their lacrimal sacs incised and drained, 300 had grommets inserted in their lacrimal in an attempt to achieve patency, 225 had lacrimal stents, and 415 had undergone fistulization.
Results
Of the 255 incisions and drainages, 65% were blocked after 2 months. Of the 300 who had grommets inserted, 68% were blocked after 2 months. Of the 225 who had lacrimal stents, all were patent but 10 (4%) had to be removed because of corneal opacities, and 1 (0.4%) had to be removed because of a foreign body granuloma at the punctum. Of the 415, 5 (1.2%) were blocked after 6 months and 1 (0.2%) patient had epiphora even though the sac was patent.
Conclusions
1) Fistulization and stenting are statistically more reliable in achieving resolution of epiphora, restoration of patency, and complete resolution of chronic dacryocystitis. 2) In our experience, we encountered corneal opacities following stenting and since the results with fistulization were comparable to stenting, we prefer to fistulize patients for chronic dacryocystitis as a safe and reliable method.
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