Comparison between nasolacrimal syringing/probing, macrodacryo-cystography and surgical findings in the management of epiphora

ABSTRACT _Aims_ Macrodacryocystography (MDCG) has been shown to be highly sensitive in evaluating the lacrimal drainage system. We aimed to compare the results of syringing/ probing with

MDCG, and with surgical findings where available. We also aimed to determine whether MDCG is advisable in addition to syringing/probing when investigating epiphora. _Methods_ In a

retrospective study, we looked at the records of 76 consecutive patients (86 eyes) presenting with epiphora over a period of 2 years (January 1993 to December 1994). All patients underwent

syringing/probing and subsequent MDCG to determine the presence and level of nasolacrimal block. The results were then compared with surgical findings where available (46 eyes, 53%).

_Results_ Surgical findings were predicted by MDCG in 95.5% of cases but in only 54% by probing. Probing findings agreed with MDCG in only 51% of cases. The main areas of disagreement were

the presence of canalicular blocks and the presence of more than one block at different levels. _Conclusion_ A combination of syringing/ probing and MDCG provides the most accurate

pre-operative lacrimal assessment and should predict all the canalicular stenoses requiring intubation. In addition, MDCG can predict physiological duct blocks beyond canalicular blocks and

thus alter surgical management. SIMILAR CONTENT BEING VIEWED BY OTHERS CLINICAL CHARACTERISTICS AND CYTOLOGICAL CHANGES IN MUCINOUS OBSTRUCTION DIAGNOSED BY DACRYOENDOSCOPY Article Open

access 17 April 2024 THE TECHNIQUE AND ITS ROLE OF DACRYOENDOSCOPY IN THE MANAGEMENT OF THE FALSE PASSAGE OF THE LACRIMAL DRAINAGE SYSTEM Article Open access 28 December 2022 EVALUATION OF

LACRIMAL DRAINAGE SYSTEM IN PSEUDOEXFOLIATION SYNDROME Article 13 October 2021 ARTICLE PDF REFERENCES * Keast-Butler J, Lloyd GAS, Welham RAN . Analysis of intubation macrodacryocystography

with surgical correlations. _Trans Ophthalmol Soc UK_ 1973;93:593–6. Google Scholar  * Rose JDG, Clayton CB . Scintigraphy and contrast radiography for epiphora. _Br J Radiol_

1985;58:1183–6. Article  CAS  Google Scholar  * Lloyd GAS, Jones BR, Wehlam RAN . Intubation macrodacryocystography. _Br J Ophthalmol_ 1972;56:600–7. Article  CAS  Google Scholar  * Dutton

JJ . Diagnostic tests and imaging techniques. In: Lindberg JV, editor. Contemporary issues in ophthalmology: lacrimal surgery. Edinburgh: Churchill Livingstone, 1988:19–48. * Zappia RJ,

Milder B . The fluorescein dye disappearance test. _Am J Ophthalmol_ 1972;74:160–2. Article  CAS  Google Scholar  * Flach A . The fluorescein appearance test for lacrimal obstruction. _Ann

Ophthalmol_ 1979;11:237–42. CAS  PubMed  Google Scholar  * Hornblass A . A simple test for lacrimal obstruction. _Arch Ophthalmol_ 1973;90:435–6. Article  CAS  Google Scholar  * Welham RAN .

The lacrimal drainage apparatus. In: Miller S, editor. Clinical ophthalmology. Bristol: Wright, 1987:391–411. * Hanna IT, MacEven CJ, Kennedy N . Lacrimal scintigraphy in the diagnosis of

epiphora. _Nuclear Med Commun_ 1992;13:416–20. Article  CAS  Google Scholar  * Glatt JH, Chan AC, Barret L . Evaluation of dacryocystorhinostomy failure with computed tomography and computed

tomographic dacryocystography. _Am J Ophthalmol_ 1991;112:431–6. Article  CAS  Google Scholar  * Ewing AE . Roentgen ray demonstration of lacrimal abscess cavity. _Am J Ophthalmol_

1964;26:1–4. Google Scholar  * Campbell W . The radiology of the lacrimal system. _Br J Radiol_ 1964;37:1–26. Article  CAS  Google Scholar  * Lloyd GAS, Welham RAN . Subtraction

macrodacryocystography. _Br J Radiol_ 1974;47:379–82. Article  CAS  Google Scholar  * Rycroft BW . Observation on cornea-plastic surgery. _Proc R Soc Med_ 1960;53:303–10. CAS  PubMed  PubMed

Central  Google Scholar  * Mannor GE, Millman AL . Prognostic value of pre-operative dacryocystography in endoscopic DCR. _Am J Ophthalmol_ 1992;113:134–7. Article  CAS  Google Scholar 

Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Ophthalmology, Leeds General Infirmary, Leeds, UK S Irfan & A Cassels-Brown * Department of

Neuroradiology, Leeds General Infirmary, Leeds, UK M Nelson Authors * S Irfan View author publications You can also search for this author inPubMed Google Scholar * A Cassels-Brown View

author publications You can also search for this author inPubMed Google Scholar * M Nelson View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND

PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Irfan, S., Cassels-Brown, A. & Nelson, M. Comparison between nasolacrimal syringing/probing,

macrodacryo-cystography and surgical findings in the management of epiphora. _Eye_ 12, 197–202 (1998). https://doi.org/10.1038/eye.1998.47 Download citation * Issue Date: 01 March 1998 *

DOI: https://doi.org/10.1038/eye.1998.47 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not

currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * Canalicular block * Dacryocystorhinostomy * Epiphora *

Nasolacrimal intubation * Nasolacrimal syringing * Macrodacryocystography