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Abstract ID: 24-149
Tear fluid dynamics evaluation for nasolacrimal duct obstruction after endoluminal lacrimal duct obstruction and dacryocystorhinostomy
Tomoyuki Kamao
Purpose
We evaluated the tear fluid dynamics using anterior segment optical coherence tomography (AS-OCT) for primary acquired nasolacrimal duct obstruction (PANDO) after treatment with endoluminal lacrimal duct obstruction (ELDR) and endoscopic-dacryocystorhinostomy (EN-DCR).
Methods
Thirty-six PANDO treated with ELDR (ELDR group), 53 PANDO treated with EN-DCR (DCR group), and 46 normal subjects (N group) were enrolled in this study. The mean ages were 72.5 ± 6.4 (ELDR group), 71.2 ± 15.6 (DCR group), and 71.4 ± 10.5 (N group), respectively. All patients who were performed lacrimal irrigation after 6 months of treatment through the lower canaliculus and the absence of reflux were included. To evaluate the tear fluid dynamics, 5 microliters of saline were applied into the lower conjunctival sac, and an image of the tear meniscus area (TMA) was obtained using AS-OCT at the center of the lower eyelid for 5 minutes with natural blinking in intervals. TMA was measured before and immediately after applied, 30 seconds later, and every minute for 5 minutes. TMA at the time of measurement and its rate of change were compared among the three groups.
Results
TMA was significantly higher in the DCR group than in the ELDR (30 sec: p=0.0137, 60 sec: p=0.0100) and N groups (30 sec: p=0.0323, 60 sec: p=0.0446) at 30 and 60 seconds after application. The ELDR and N groups showed no significant difference in TMA during 5 minutes. The change rate for the DCR group was significantly lower than that of the N groups (p=0.0443).
Conclusion
The results suggest that the tear fluid dynamics of the ELDR group returned to normal after surgery. On the other hand, the DCR group remained slightly deteriorated in tear fluid clearance.
Additional Authors
Arisa Mitani – Ehime University
Atsushi Shiraishi – Ehime University