ABSTRACT

To compare lacrimal scintigraphy and dacriocystography in the diagnosis of patients with epiphora and selection of surgical technique.

Eighty-eight patients (93 eyes) who have been admitted to our clinic with epiphora between the years 2010-2011 were evaluated prospectively. Sixty-three (71.6%) were female and 25 (28.4%) were male. The mean age was 51.7 (14-77) years. Patients who have normal eyelid position, normal punctum and nasal examination, complaining of epiphora and no ocular surface disease were included in the study. All patients underwent lacrimal scintigraphy and dacriocystography. With dacriocystography, the location of the obstruction, filling defect, presence of diverticula and size of the sac were assessed. The presence and location of the obstruction was evaluated with lacrimal scintigraphy.

Nasolacrimal obstruction was detected in 81 (87%) eyes with dacriocystography and in 89 (95.6%) with lacrimal scintigraphy. Dacryosistography detected partial obstruction in 4 of 8 eyes in which lacrimal scintigraphy detected obstruction, the channel clearness was detected in 3 eyes and eyelid laxity in 1 eye. Obstruction was detected in eight of 8 eyes with lacrimal scintigraphy but contrast was observed in the nasal cavity with dacriocystography; ducts were open anatomically, but functional nasolacrimal duct obstruction was found in these eyes. Partial stenosis was detected with lacrimal scintigraphy in 4 patients in which complete stenosis of the nasolacrimal duct was found with dacriocystography. Partial stenosis was found in Jones tests of these 4 cases. Lacrimal scintigraphy localized more proximal obstruction than dacriocystography in 8 eyes.

Lacrimal scintigraphy enables us to show the function of the nasolacrimal drainage system. However, in the nasolacrimal system obstructions, because dacriocystography provides more information about the level of obstruction and anatomy of the lacrimal canal, it is a valuable method and the first choice in the diagnosis and planning of surgery. (JAREM 2012; 2: 68-70)

Keywords: Lacrimal scintigraphy, dacriocystography, nasolacrimal duct obstruction, dacryostenosis, epiphora