COMPARISON BETWEEN NASOLACRIMAL SYRINGING PROBING, MACRODACRYOCYSTOGRAPHY AND SURGICAL FINDINGS IN THE MANAGEMENT OF EPIPHORA/

Aims Macrodacryocystography (MDCG) has been shown to be highly sensiti ve in evaluating the lacrimal drainage system. We aimed to compare the results of syringing/ probing with MDCG, and with surgical findings w here available. We also aimed to determine whether MDCG is advisable i n addition to syringing/probing when investigating epiphora. Methods I n a retrospective study, we looked at the records of 76 consecutive pa tients (86 eyes) presenting with epiphora over a period of 2 years (Ja nuary 1993 to December 1994). All patients underwent syringing/probing and subsequent MDCG to determine the presence and level of nasolacrim al block. The results were then compared with surgical findings where available (46 eyes, 53%). Results Surgical findings were predicted by MDCG in 95.5% of cases but in only 54% by probing. Probing findings ag reed with MDCG in only 51% of cases. The main areas of disagreement we re the presence of canalicular blocks and the presence of more than on e block at different levels. Conclusion A combination of syringing/ pr obing and MDCG provides the most accurate pre-operative lacrimal asses sment and should predict all the canalicular stenoses requiring intuba tion. In addition, MDCG can predict physiological duct blocks beyond c analicular blocks and thus alter surgical management.