Document Detail


External dacryocystorhinostomy surgery in patients with Wegener granulomatosis.
MedLine Citation:
PMID:  23034682     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine surgical outcomes after external dacryocystorhinostomy (DCR) surgery in patients with Wegener granulomatosis (WG).
METHODS: The authors retrospectively reviewed the charts of consecutive patients with WG who underwent primary or secondary external DCR surgery between January 2001 and January 2010. Clinical data reviewed included patient demographics, systemic disease involvement and immunosuppression therapy, intraoperative biopsy findings, and postoperative outcomes and complications. Success was defined as resolution of epiphora.
RESULTS: Sixteen primary external DCRs were performed on 9 patients with WG, and 2 secondary external DCRs were performed on 2 patients. At the time of surgery, all patients with WG were on systemic immunosuppressive agents including methotrexate, rapamycin, sirolimus, tacrolimus, azathioprine, cyclophosphamide, rituximab, and prednisone, and no patients received increased corticosteroids after surgery. Intraoperative biopsy in patients with WG revealed chronic inflammation (4 patients) and fibrosis (1 patient). Silicone stents were removed at an average of 5.8 months (range, 3-12 months). All surgeries were successful in resolving epiphora with an average follow up of 3.5 years (range, 10 months-6 years) and no complications.
CONCLUSIONS: Primary and secondary external DCR surgery successfully treats nasolacrimal duct obstruction in patients with WG on systemic immunosuppression.
Authors:
Brian J Lee; Christine C Nelson; Craig D Lewis; Julian D Perry
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ophthalmic plastic and reconstructive surgery     Volume:  28     ISSN:  1537-2677     ISO Abbreviation:  Ophthal Plast Reconstr Surg     Publication Date:    2012 Nov-Dec
Date Detail:
Created Date:  2012-11-09     Completed Date:  2013-03-08     Revised Date:  2013-05-08    
Medline Journal Info:
Nlm Unique ID:  8508431     Medline TA:  Ophthal Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  389-92     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Dacryocystorhinostomy*
Female
Humans
Immunosuppressive Agents / therapeutic use
Lacrimal Duct Obstruction / etiology,  surgery*
Male
Middle Aged
Nasolacrimal Duct / surgery*
Retrospective Studies
Treatment Outcome
Wegener Granulomatosis / complications*,  drug therapy
Young Adult
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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