Functional Epiphora Management Via Different Dacryocystorhinostomy (DCR) Techniques

Study Overview
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Brief Summary
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135 eyes of 135 patients treated between 2005 and 2017 will be included in this study. The diagnosis of functional epiphora was made based on a patent lacrimal system with a delay in the fluorescein dye disappearance test (FDDT) or dacryoscintigraphy (DSG) without any ocular surface or eyelid abnormalities. The absence of epiphora and normalization of FDDT postoperatively was defined as success. The study's hypothesis is that external DCR with a suitable technique will have better results compared to endonasal and transcanalicular DCR

Official Title
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Non-endoscopic Endonasal, Transcanalicular, or External Dacryocystorhinostomy for Functional Epiphora: Which is Better?

Conditions
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Functional Epiphora (Tearing Without Any Anatomical Block)

Intervention / Treatment
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* Procedure: External Dacryocystorhinostomy
* Procedure: Endonasal Dacryocystorhinostomy
* Procedure: Transcanalicular Dacryocystorhinostomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patent lacrimal irrigation and delay in the lacrimal transit time demonstrated by fluorescein dye disappearance test (FDDT) or a dacryoscintigraphy (DSG) Exclusion Criteria: Dry eye (tear break up time less than 10 seconds), ocular surface disorders, eyelid malposition or laxity, orbicularis weakness, partial block or stenosis of the lacrimal drainage, history of previous nasal, lacrimal, or ophthalmic surgeries, and a postoperative follow-up time less than six months

Ages Eligible for Study
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Minimum Age: 21 Years


Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: External DCR<br>Patients treated with External DCR for functional epiphora | Procedure: External Dacryocystorhinostomy<br>* The resistance of the lacrimal drainage is lowered by creating a new ostium between the lacrimal sac and nasal cavity via skin incision.<br>|
| Active Comparator: Endonasal DCR<br>Patients treated with Endonasal DCR for functional epiphora | Procedure: Endonasal Dacryocystorhinostomy<br>* The resistance of the lacrimal drainage is lowered by creating a new ostium between the lacrimal sac and nasal cavity via endonasal route.<br>|
| Active Comparator: Transcanalicular DCR<br>Patients treated with Transcanalicular DCR for functional epiphora | Procedure: Transcanalicular Dacryocystorhinostomy<br>* The resistance of the lacrimal drainage is lowered by creating a new ostium between the lacrimal sac and nasal cavity via transcanalicular route.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of patients who report resolution of theri tearing and normalization of fluorescein dye disappearance test. |  | Last follow-up time, approximately 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients who have continuing epiphora after the surgery with an anatomically blocked tear duct. |  | Last follow-up time, approximately 6 months |