Clinical Results of Anti-adhesion Adjuvants after Endonasal Dacryocystorhinostomy

Korean J Ophthalmol. 2018 Dec;32(6):433-437. doi: 10.3341/kjo.2017.0124.

Abstract

Purpose: Various absorbable anti-adhesion agents have been used to prevent postoperative synechia formation after endonasal surgery. The purpose of this study was to evaluate the anti-adhesion effects of HyFence and Mediclore after endonasal dacryocystorhinostomy (DCR) compared to a mixed solution of hyaluronic acid and sodium carboxymethylcellulose (Guardix-Sol).

Methods: In this retrospective study, endonasal DCR and silicone tube intubation were performed on 198 eyes of 151 patients. Three different anti-adhesion adjuvants were applied to the osteotomy site in the nasal cavity after standard endonasal DCR procedures. The subjects were classified into three respective groups: group A (71 eyes, Guardix-Sol 1.5 g), group B (89 eyes, HyFence 1.5 mL), and group C (38 eyes, Mediclore 1 cc). The three groups were evaluated by asking patients about subjective symptoms and by performing lacrimal irrigation tests and endoscopic examinations.

Results: There were no statistically significant differences in age, sex, timing of tube removal, or follow-up period among the three groups. There were no statistically significant differences in success rates among the three groups (p = 0.990, 91.5% [65 / 71], 92.1% [82 / 89], and 92.1% [35 / 38], respectively).

Conclusions: HyFence and Mediclore are safe and effective adjunctive modalities following endonasal DCR compared to Guardix-Sol. Therefore, these agents can be considered good alternatives to Guardix-Sol to increase the success rate of endonasal DCR in treating patients with poor prognosis.

Keywords: Anti-adhesion adjuvants; Endonasal dacryocystorhinostomy; HyFence; Mediclore.

MeSH terms

  • Cell Adhesion / drug effects*
  • Chemotherapy, Adjuvant*
  • Dacryocystorhinostomy / methods*
  • Female
  • Humans
  • Intubation
  • Male
  • Middle Aged
  • Nasal Cavity / surgery
  • Nasolacrimal Duct / surgery*
  • Pharmaceutical Preparations / administration & dosage*
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Silicone Elastomers

Substances

  • Pharmaceutical Preparations
  • Silicone Elastomers