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Lacrimal drainage function after cheese wiring of lacrimal passage intubation

  • Oculoplastics and Orbit
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Abstract

Purpose

To investigate how cheese wiring affects lacrimal drainage function by quantitative assessment of tear function and punctal dimensions.

Methods

Patients who underwent lacrimal passage intubation between January 2017 and September 2018 were enrolled prospectively. Among these patients, those with postoperative cheese wiring who received lacrimal passage intubation in one eye met the criteria for further investigation. The subjective symptoms of epiphora, dimensions of puncta, lower tear meniscus, and tear clearance were assessed postoperatively in both the involved eye and untreated contralateral eye. Punctum dimensions were analysed using the digital slit-lamp image. Tear meniscus and tear clearance were assessed by anterior segment optical coherence tomography.

Results

Postoperative cheese wiring was observed in 68 of 314 eyes. Among these cases, 36 patients (age 70.5 ± 11.7 years) had cheese wiring only in one eye: with the involvement of both puncta in 15 patients (group A) and only the lower punctum in 21 patients (group B). There was no patient with the involvement of only the upper punctum. While tear function of the involved eyes in group B did not differ from that of the untreated eye, it was significantly decreased in group A compared with that in untreated control eyes (p < 0.05). The tear clearance rate correlated significantly with the upper punctum dimensions (p < 0.05), but not with the lower punctum.

Conclusion

Analysis of cheese wiring after lacrimal passage intubation with tear function demonstrated that the integrity of the puncta and the canaliculus is important for lacrimal drainage.

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References

  1. Pashby RC, Rathbun JE (1979) Silicone tube intubation of the lacrimal drainage system. Arch Ophthalmol 97(7):1318–1322 https://doi.org/10.1001/archopht.1979.01020020060014

    Article  CAS  Google Scholar 

  2. Pierroth L, Della Rocca DA, Della Rocca RC (2007) Nasolacrimal probing and intubation. In: Weber RK, Keerl R, Schaefer SD, Della Rocca RC (eds) Atlas of lacrimal surgery. Springer, Berlin, Heidelberg, pp 53–59

    Chapter  Google Scholar 

  3. Rokohl AC, Guo Y, Mor JM, Loreck N, Koch KR, Heindl LM (2019) Intubation systems in lacrimal drainage surgery - a current overview. Klin Monbl Augenheilkd https://doi.org/10.1055/a-0992-9966[Epub ahead of print]

  4. Benger RS, Nemet AY (2008) Peripunctal “anchor” suture for securing the silicone bicanalicular stent in the repair of canalicular lacerations. Ophthal Plast Reconstr Surg 24:51–53 https://doi.org/10.1097/iop.0b013e31815c937c

    Article  Google Scholar 

  5. Fayers T, Dolman PJ (2016) Bicanalicular silicone stents in endonasal dacryocystorhinostomy: results of a randomized clinical trial. Ophthalmology 123:2255–2259 https://doi.org/10.1016/j.ophtha.2016.06.026

    Article  Google Scholar 

  6. Anuar KB, Gendeh BS (2011) Tube extrusion and cheese wiring five years post dacryocystorhinostomy. Philipp J Otolaryngol Head Neck Surg 26:25–27 https://doi.org/10.32412/pjohns.v26i2.575

    Article  Google Scholar 

  7. Anderson RL, Edwards JJ (1979) Indications, complications and results with silicone stents. Ophthalmology 86:1474–1487 https://doi.org/10.1016/s0161-6420(79)35374-x

    Article  CAS  Google Scholar 

  8. Bajaj MS, Pushker N, R B, Rani A (2002) Surgical endoscopic dacryocystorhinostomy. Br J Ophthalmol 86:1460

  9. Inatani M, Fukuchi M, Denno S, Miki M (1998) Treatment of nasolacrimal duct obstruction by intubation of U-shaped silicone tube. Jpn J Clin Ophthalmol 52:517–520 https://doi.org/10.1034/j.1600-0420.2000.078006689.x

    Google Scholar 

  10. Teranishi C (2000) Nunchaku-style tube intubation for nasolacrimal duct obstruction (report 2) complications during tube retention and removal. Jpn J Clin Ophthalmol 54:261–264

    Google Scholar 

  11. Dolman PJ (2003) Comparison of external dacryocystorhinostomy with nonlaser endonasal dacryocystorhinostomy. Ophthalmology 110:78–84 https://doi.org/10.1016/s0161-6420(02)01452-5

    Article  Google Scholar 

  12. Charalampidou S, Fulcher T (2009) Does the timing of silicone tube removal following external dacryocystorhinostomy affect patients’ symptoms? Orbit 28:115–119 https://doi.org/10.1080/01676830802674342

    Article  Google Scholar 

  13. Koh S, Inoue Y, Ochi S, Takai Y, Maeda N, Nishida K (2017) Quality of vision in eyes with epiphora undergoing lacrimal passage intubation. Am J Ophthalmol 181:71–78 https://doi.org/10.1016/j.ajo.2017.06.022

    Article  Google Scholar 

  14. Munk PL, Lin DT, Morris DC (1990) Epiphora: treatment by means of dacryocystoplasty with balloon dilation of the nasolacrimal drainage apparatus. Radiology 177:687–690 https://doi.org/10.1148/radiology.177.3.2243969

    Article  CAS  Google Scholar 

  15. Fukuda R, Usui T, Miyai T, Yamagami S, Amano S (2013) Tear meniscus evaluation by anterior segment swept-source optical coherence tomography. Am J Ophthalmol 155:620-624, 624.e1–2. https://doi.org/10.1016/j.ajo.2012.11.009

  16. Ohtomo K, Ueta T, Fukuda R, Usui T, Miyai T, Shirakawa R, Amano S, Nagahara M (2014) Tear meniscus volume changes in dacryocystorhinostomy evaluated with quantitative measurement using anterior segment optical coherence tomography. Invest Ophthalmol Vis Sci 55:2057–2061 https://doi.org/10.1167/iovs.13-12692

    Article  Google Scholar 

  17. Zheng X, Kamao T, Yamaguchi M, Sakane Y, Goto T, Inoue Y, Shiraishi A, Ohashi Y (2014) New method for evaluation of early phase tear clearance by anterior segment optical coherence tomography. Acta Ophthalmol 92:e105–e111 https://doi.org/10.1111/aos.12260

    Article  Google Scholar 

  18. Keith CG (1968) Intubation of the lacrimal passages. Am J Ophthalmol 65:70–74

    Article  CAS  Google Scholar 

  19. Psilas K, Eftaxias V, Kastanioudakis J, Kalogeropoulos C (1993) Silicone intubation as an alternative to dacryocystorhinostomy for nasolacrimal drainage obstruction in adults. Eur J Ophthalmol 3(2):71–76 https://doi.org/10.1177%2F112067219300300204

    Article  CAS  Google Scholar 

  20. Fulcher T, O’Connor M, Moriarty P (1998) Nasolacrimal intubation in adults. Br Ophthalmol 82(9):1039–1041 https://doi.org/10.1136/bjo.82.9.1039

    Article  CAS  Google Scholar 

  21. Connell PP, Fulcher TP, Chacko E, O’ Connor MJ, Moriarty P (2006) Long term follow up of nasolacrimal intubation in adults. Br J Ophthalmol 90(4):435–436. https://doi.org/10.1136/bjo.2005.084590

  22. Demirci H, Elner VM (2008) Double silicone tube intubation for the management of partial lacrimal system obstruction. Ophthalmology 115(2):383–385 https://doi.org/10.1016/j.ophtha.2007.03.078

    Article  Google Scholar 

  23. Mimura M, Ueki M, Oku H, Sato B, Ikeda T (2015) Indications for and effects of Nunchaku-style silicone tube intubation for primary acquired lacrimal drainage obstruction. Jpn J Ophthalmol 59(4):266–272 https://doi.org/10.1007/s10384-015-0381-5

    Article  Google Scholar 

  24. Mauffray RO, Hassan AS, Elner VM (2004) Double silicone intubation as treatment for persistent congenital nasolacrimal duct obstruction. Ophthal Plast Reconstr Surg 20:44–49 https://doi.org/10.1097/01.iop.0000103004.71978.0c

    Article  Google Scholar 

  25. Jones LT (1957) Epiphora. II. Its relation to the anatomic structures and surgery of the medial canthal region. Am J Ophthalmol 43:203–212

    Article  CAS  Google Scholar 

  26. Doane MG (1980) Interactions of eyelids and tears in corneal wetting and the dynamics of the normal human eyeblink. Am J Ophthalmol 89:507–516 https://doi.org/10.1016/0002-9394(80)90058-6

    Article  CAS  Google Scholar 

  27. Doane MG (1981) Blinking and the mechanics of the lacrimal drainage system. Ophthalmology 88:844–851 https://doi.org/10.1016/s0161-6420(81)34940-9

    Article  CAS  Google Scholar 

  28. Becker BB (1992) Tricompartment model of the lacrimal pump mechanism. Ophthalmology 99:1139–1145 https://doi.org/10.1016/s0161-6420(92)31839-1

    Article  CAS  Google Scholar 

  29. Kakizaki H, Takahashi Y, Mito H, Nakamura Y (2015) Movement of the lacrimal canalicular wall under intracanalicular pressure changes observed with dacryoendoscopy. Ophthal Plast Reconstr Surg 31:73–74 https://doi.org/10.1097/iop.0000000000000316

    Article  Google Scholar 

  30. Saunders DH, Shannon GM, Flanagan JC (1978) The effectiveness of the pigtail probe method of repairing canalicular lacerations. Ophthal Surg 9:33–40 https://doi.org/10.1097/00006534-197909000-00045

    CAS  Google Scholar 

  31. Meyer DR, Antonello A, Linberg JV (1990) Assessment of tear drainage after canalicular obstruction using fluorescein dye disappearance. Ophthalmology 97:1370–1374 https://doi.org/10.1016/s0161-6420(90)32408-9

    Article  CAS  Google Scholar 

  32. Ogut MS, Bavbek T, Kazokoglu H (1993) Assessment of tear drainage by fluorescein dye disappearance test after experimental canalicular obstruction. Acta Ophthalmol 71:69–72 https://doi.org/10.1111/j.1755-3768.1993.tb04963.x

    Article  CAS  Google Scholar 

  33. Yamaguchi M, Ohta K, Shiraishi A, Sakane Y, Zheng X, Kamao T, Yamamoto Y, Inoue Y, Ohashi Y (2014) New method for viewing Krehbiel flow by polymethylmethacrylate particles suspended in fluorescein solution. Acta Ophthalmol 92:e676–e680 https://doi.org/10.1111/aos.12444

    Article  CAS  Google Scholar 

  34. Kashkouli MB, Nilforushan N, Nojomi N, Rezaee R (2008) External lacrimal punctum grading: reliability and interobserver variation. Eur J Ophthalmol 18:507–511 https://doi.org/10.1177/112067210801800401

    Article  CAS  Google Scholar 

  35. Lemp MA, Weiler HH (1983) How do tears exit? Invest Ophthalmol Vis Sci 24:619–622

    CAS  PubMed  Google Scholar 

  36. Wawrzynski JR, Smith J, Sharma A, Saleh GM (2014) Optical coherence tomography imaging of the proximal lacrimal system. Orbit 33:428–432 https://doi.org/10.3109/01676830.2014.949793

    Article  Google Scholar 

  37. Allam RS, Ahmed RA (2015) Evaluation of the lower punctum parameters and morphology using spectral domain anterior segment optical coherence tomography. J Ophthalmol 591845 https://doi.org/10.1155/2015/591845

  38. Kamal S, Ali MJ, Ali MH, Naik MN (2016) Fourier domain optical coherence tomography with 3D and en face imaging of the punctum and vertical canaliculus: a step toward establishing a normative database. Ophthal Plast Reconstr Surg 32:170–173 https://doi.org/10.1097/iop.0000000000000396

    Article  Google Scholar 

  39. Timlin HM, Keane PA, Day AC, Salam T, Abdullah M, Rose GE, Ezra DG (2016) Characterizing the lacrimal punctal region using anterior segment optical coherence tomography. Acta Ophthalmol 94:154–159 https://doi.org/10.1111/aos.12906

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Shizuka Koh

  2. Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan

    Shizuka Koh

  3. Inoue Eye Clinic, Okayama, Japan

    Shintaro Ochi & Yasushi Inoue

Authors
  1. Shizuka Koh
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  2. Shintaro Ochi
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  3. Yasushi Inoue
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Contributions

Study concept and design (SK, SO, YI); data collection (SO, YI); analysis and interpretation of data (SK, SO, YI); writing the manuscript (SK, SO, YI); critical revision of the manuscript (SK, SO, YI). All authors read and approved the final manuscript.

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Correspondence to Shizuka Koh.

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The authors declare that they have no conflicts of interest.

Research involving human participants

This prospective study was conducted after the approval of the Institutional Review Board of Osaka University Hospital (09297-19). The study adhered to the 1964 Helsinki declaration and its later amendments.

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All patients were informed about the nature and possible consequences of the study; following which, they provided written informed consent.

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Koh, S., Ochi, S. & Inoue, Y. Lacrimal drainage function after cheese wiring of lacrimal passage intubation. Graefes Arch Clin Exp Ophthalmol 258, 1087–1093 (2020). https://doi.org/10.1007/s00417-020-04612-z

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  • DOI: https://doi.org/10.1007/s00417-020-04612-z

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