Purpose: To evaluate the long-term functional outcome in patients undergoing a canaliculoplasty that turns the lacrimal sac inside out for extended canalicular stenosis, and to determine the place of this technique in comparison with other surgical techniques proposed for this difficult condition.
Methods: A retrospective study was conducted over a ten-year period (1990-2000). Thirty-eight patients (21 men and 17 women) were included. Mean age was 48.8 years, range 11-81 years. We evaluated the long-term outcome in 25 patients. Among these patients, canalicular stenosis had developed after infection in 16 and after trauma in 9.
Results: The rate of success was 52% at nine years. Success appeared to be more frequent in trauma victims (75%) than after infection (43%). The rate of success was better for patients with monocanalicular (60%) than for those with bicanalicular stenosis (40%). Digital dacryography demonstrated good flow of the contrast product through the neocanaliculus into the nasal fossa in eight of ten patients explored.
Conclusion: We were able to achieve complete cure in many patients with an overall success rate of 50%. Digital dacryography with dye flow provides good opacification of the neocanaliculus, demonstrating its nearly physiological morphology. Our study demonstrated the usefulness of this method and has encouraged us to continue proposing this canaliculoplasty technique for selected patients.