Long-term outcomes of labial mucosal graft in conjunctivo-rhinostomy surgery.

OBJECTIVE

To report the long-term outcomes of the conjunctivo-rhinostomy surgery with labial mucosal graft performed for the patients of proximal lacrimal drainage system disorders.

METHODS

Retrospective, single surgeon (KB), non-comparative study including patients having complete obstruction of the superior and inferior proximal lacrimal drainage system. All patients underwent conjunctivo-rhinostomy with labial mucosal graft insertion. Preoperatively, tear film break-up time and a fluorescein dye disappearance test was performed for each patient. A phaco aspiration tubing segment was used for supporting the mucosal graft for first 4 weeks followed by its removal. Minimum follow-up was 12 months. fluorescein dye disappearance test and nasal endoscopy were performed at each follow-up visit. Total resolution of epiphora and negative fluorescein dye disappearance test was defined as complete success.

RESULTS

Eighteen patients (12 males, 6 females) with a mean age of 39.94 years (range 7-76 years) all had a unilateral presentation. The indication for surgery was trauma (n = 11), failed dacryocystorhinostomy (DCR) with canalicular obstruction (n = 4), chronic ocular inflammation with complete punctal occlusion (n = 2), and post-radiotherapy (n = 1). At a mean follow-up of 5.38 years, complete success was observed in 12 (66.67%), partial success in 4 (22.22%) while in 2 (11.11%) patients, the procedure failed.

CONCLUSION

Labial mucosal graft in conjunctivo-rhinostomy is a successful adjunct which provides satisfactory long-term outcomes. Our surgical technique of directly suturing the mucosal graft to surrounding muscle provides better functionality to the system with eyelid blinking.