A modified technique of retrograde intubation dacryocystorhinostomy for proximal canalicular obstruction

Case report

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Authors: Nikolaos Trakos, Emmanouil Mavrikakis, Kostas G Boboridis, et al

Published Date November 2009 Volume 2009:3 Pages 681 - 684

DOI: http://dx.doi.org/10.2147/OPTH.S7790

Nikolaos Trakos, Emmanouil Mavrikakis, Kostas G Boboridis, Marselos Ralidis, George Dimitriadis, Ioannis Mavrikakis

Oculoplastic Service, Metropolitan Hospital, Athens, Greece

Purpose: To describe a modification of the retrograde intubation dacryocystorhinostomy (DCR) in patients with proximal canalicular obstruction.

Materials and methods: Interventional case report of a 43-year-old female with a nine-month history of left epiphora following a road traffic accident involving the proximal lower canaliculus. An external DCR approach was performed. Following the creation of a lower canalicular pseudopunctum, the O’Donoghue silicone stent was introduced through the common ostium, out through the pseudopunctum of the lower canaliculus, and returned through the punctum of the normal upper canaliculus down through the common ostium into the nose.

Results: The patient experienced complete resolution of symptoms and on her last follow-up, two years later, her lower canaliculus was patent to syringing.

Conclusion: This modification of the retrograde intubation DCR is an effective technique which decreases the intraoperative time needed to insert the tubes and minimises further trauma to the newly created punctal area.

Keywords: retrograde dacryocystorhinostomy, proximal canalicular obstruction, midcanalicular obstruction, conjuctivodacryocystorhinostomy