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Войти в исследования Indian journal of ophthalmology · 2026
Partial orbital lobe dacryoadenectomy for refractory epiphora.
СтатьяНазвание и аннотация: Перевод в очереди
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Shree Neha, Rehman Obaidur, Narula Chhavi Gupta, Kumari Namita, Das Sima
Аннотация
PURPOSE: To evaluate the efficacy of partial orbital lobe dacryoadenectomy (POLD) in patients with refractory epiphora.
DESIGN: Prospective interventional study.
SETTING: Tertiary eye care institute.
STUDY POPULATION: Consecutive patients with refractory epiphora due to proximal lacrimal outflow system obstruction, multiple failed dacryocystorhinostomy, and postdacryocystectomy. All patients underwent preoperative assessment with Munk score, Schirmer-I Score, tear breakup time, corneal fluorescein staining, anterior segment OCT (AS-OCT), and CT scans of the orbit.
INTERVENTION: Partial removal of the lacrimal gland orbital lobe under local anesthesia.
MAIN OUTCOME MEASURE: Reduction in epiphora. Objective and subjective evaluation was repeated at postoperative 1-week, 1-month, and 3-month visits.
RESULTS: Out of 17 patients enrolled, one had congenital punctal agenesis, three had acquired punctal effacement, and 13 had proximal bicanalicular obstruction. The mean age was 48.8 ± 18.6 years. All patients underwent POLD, with removal of 50-60% of the orbital lobe of the lacrimal gland. The mean follow-up duration was 5.7 months. At 3-month follow-up visit, the average reduction in Munk score was 60%, the average reduction in Schirmer-I value was 35.2%, and the average reduction in tear film height on AS-OCT was 35.9% (all statistically significant, P < 0.05), from the initial visit. None of the patients developed signs and symptoms of dry eye disease.
CONCLUSION: POLD is an effective and safe procedure for patients with refractory epiphora in the short term. Further studies are needed to establish efficacy in the long term.
DESIGN: Prospective interventional study.
SETTING: Tertiary eye care institute.
STUDY POPULATION: Consecutive patients with refractory epiphora due to proximal lacrimal outflow system obstruction, multiple failed dacryocystorhinostomy, and postdacryocystectomy. All patients underwent preoperative assessment with Munk score, Schirmer-I Score, tear breakup time, corneal fluorescein staining, anterior segment OCT (AS-OCT), and CT scans of the orbit.
INTERVENTION: Partial removal of the lacrimal gland orbital lobe under local anesthesia.
MAIN OUTCOME MEASURE: Reduction in epiphora. Objective and subjective evaluation was repeated at postoperative 1-week, 1-month, and 3-month visits.
RESULTS: Out of 17 patients enrolled, one had congenital punctal agenesis, three had acquired punctal effacement, and 13 had proximal bicanalicular obstruction. The mean age was 48.8 ± 18.6 years. All patients underwent POLD, with removal of 50-60% of the orbital lobe of the lacrimal gland. The mean follow-up duration was 5.7 months. At 3-month follow-up visit, the average reduction in Munk score was 60%, the average reduction in Schirmer-I value was 35.2%, and the average reduction in tear film height on AS-OCT was 35.9% (all statistically significant, P < 0.05), from the initial visit. None of the patients developed signs and symptoms of dry eye disease.
CONCLUSION: POLD is an effective and safe procedure for patients with refractory epiphora in the short term. Further studies are needed to establish efficacy in the long term.