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Yartsev V.D.

Krasnov Research Institute of Eye Diseases

Atkova E.L.

Krasnov Research Institute of Eye Diseases

Lipatov D.V.

National Medical Research Center for Endocrinology

Dacryocystorhinostomy with a counteropening in the treatment of secondary nasolacrimal duct obstruction after radioiodine therapy

Authors:

Yartsev V.D., Atkova E.L., Lipatov D.V.

More about the authors

Journal: Russian Annals of Ophthalmology. 2024;140(2‑2): 60‑67

DOI: 10.17116/oftalma202414002260

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To cite this article:

Yartsev VD, Atkova EL, Lipatov DV. Dacryocystorhinostomy with a counteropening in the treatment of secondary nasolacrimal duct obstruction after radioiodine therapy. Russian Annals of Ophthalmology. 2024;140(2‑2):60‑67. (In Russ.)
https://doi.org/10.17116/oftalma202414002260

Подписка 2025 (Russian Annals of Ophthalmology)
 
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Among secondary forms of nasolacrimal duct obstruction caused by radioactive iodine therapy, its distal forms localized in the area of the Hasner’s valve are predominant. In this regard, during dacryocystorhinostomy (DCR) there is a high probability of developing the sump syndrome, for which the anatomical prerequisite is that the lower edge of the DCR ostium is above the level of obstruction. In such cases, we propose to supplement DCR with a counteropening in the area of the Hasner’s valve.

PURPOSE

This study analyzes the clinical effectiveness of dacryocystorinostomy with a counteropening.

MATERIAL AND METHODS

The outcomes of 49 surgeries (49 patients) with secondary acquired nasolacrimal duct obstruction due to radioactive iodine therapy were analyzed, including 34 DCR and 15 DCR with a counteropening. The clinical outcomes were analyzed over the longest possible period after surgery. The analysis included the severity of tearing on the Munk scale, the characteristic of the formed ostium on the M. Ali scale and the height of the tear meniscus. Differences were considered significant at a confidence level of 95% (p≤0.05).

RESULTS

Analysis of the results of the performed surgeries showed that DCR was clinically effective in 30 (88%) cases, DCR with a counteropening — in 15 (100%) cases. The differences were not statistically significant in the total sample, but were statistically significant when comparing the results of surgeries in patients with distal obliteration.

CONCLUSION

The developed and clinically tested method of DCR with a counteropening in the area of the Hasner’s valve was completely effective in 15 patients with secondary nasolacrimal duct obstruction caused by radioiodine therapy.

Keywords:

dacryocystorhinostomy
radioiodine treatment

Authors:

Yartsev V.D.

Krasnov Research Institute of Eye Diseases

Atkova E.L.

Krasnov Research Institute of Eye Diseases

Lipatov D.V.

National Medical Research Center for Endocrinology

Received:

25.12.2023

Accepted:

11.02.2024

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