Kosei Tomita
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Ophthalmology 1,
   Position   Instructor
Article types 原著
Language English
Peer review Peer reviewed
Title Two cases of nasolacrimal duct obstruction operated by endoscopic dacryocystorhinostomy after orbital fracture reconstruction with an implant.
Journal Formal name:American journal of ophthalmology case reports
Abbreviation:Am J Ophthalmol Case Rep
ISSN code:24519936/24519936
Domestic / ForeginForegin
Volume, Issue, Page 30,pp.101853
Author and coauthor Kosei Tomita, Hiroko Matsuyama, Masayuki Akimoto
Authorship Lead author,Corresponding author
Publication date 2023/06
Summary PURPOSE:To report two cases of nasolacrimal duct obstruction (NLDO) caused by orbital fracture reconstruction with an implant successfully treated with endoscopic dacryocystorhinostomy (EnDCR).OBSERVATIONS:Two patients presented with NLDO after orbital fracture reconstruction with an implant. Case 1 was a 67-year-old female. She became aware of epiphora in her left eye after undergoing orbital fracture reconstruction with an implant for a left orbital floor fracture 14 years previously. Dacryocystitis was diagnosed based on a lacrimal syringing test because of pus reflux. Computed tomography (CT) showed that the implant was inserted on the left orbital floor, crossing into the lacrimal sac; dacryoendoscopy showed that the implant blocked the nasolacrimal duct. EnDCR was performed without implant removal. The symptoms resolved postoperatively. Case 2 involved a 6-year-old male who had been aware of epiphora in his left eye since undergoing orbital fracture reconstruction with an implant for a left orbital floor fracture one month prior. Dacryocystitis was diagnosed based on a lacrimal syringing test because of pus reflux. CT showed an unclear implant location, but dacryoendoscopy showed that the implant blocked the nasolacrimal duct. The implant was removed. However, EnDCR was performed because there was no improvement in NLDO. The symptoms resolved after EnDCR.CONCLUSIONS AND IMPORTANCE:One previous report of NLDO after orbital floor fracture reconstruction was performed with external dacryocystorhinostomy with implant removal. Dacryoendoscopy and CT are useful for confirming the location of the implant and obstruction. Depending on the implant's location, it may be possible to perform EnDCR without removing the implant.
DOI 10.1016/j.ajoc.2023.101853
PMID 37168519
URL for researchmap https://www.sciencedirect.com/science/article/pii/S2451993623000610?via%3Dihub