This article is part of Ophthalmology Advisor’s conference coverage from the 2021 Fall Scientific Symposium of the American Society of Ophthalmic Plastic and Reconstructive Surgery, held in New Orleans from November 11 to 12, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the oculoplastic researchers and other clinicians at the ASOPRS. Check back for more from the ASOPRS 2021 Fall Scientific Symposium.

At the 2021 meeting of the American Society of Ophthalmic Plastic and Reconstructive Surgery, researchers from Boston University School of Medicine and Harvard Medical School, Boston, presented data comparing outcomes of symptom relief following external or endoscopic dacryocystorhinostomy (DCR) for radioactive iodine–associated (RAI) nasolacrimal duct obstruction (NLDO) vs outcomes with DCR for primary acquired nasolacrimal duct obstruction (PANDO). 

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A retrospective chart review of medical records identified patients with RAI NLDO who underwent external or endoscopic DCR from January 2000 to January 2021 from a single institution. A 3:1 age and sex-matched control population was identified consisting of patients who underwent DCR for PANDO with no history of treatment with radioactive iodine. All included patients were undergoing their first DCR, and no repeat cases were included. Complete symptomatic relief was the target success endpoint, specifically symptom relief without need for additional surgeries. Fisher exact test and a 2-sided unpaired student t-test were used to compare outcomes, with (P <.05). 

In total, 14 cases of NLDO were included; 6 patients underwent external DCR and 8 were treated by endoscopic DCR. The mean age of patients with RAI NLDO was 41.6±16.6 years, and the mean age of the control population (n=42) was 42.2±16.2 years (P =.849). The mean dose of radioactive iodine 131 received was 153.6 ± 67.5 mCi. In all but 2 of the RAI cases, complete symptom relief was achieved without the need for additional surgeries. In the RAI group, 78.6% of patients experienced complete symptom relief, compared with 87.2% in the control group (P =.422). For external DCR cases, 83.3% of RAI cases and 86.7% of control cases reached complete symptom control (P =1.000). For endoscopic DCR cases, 75% of RAI cases and 87.5% of control cases achieved complete symptom control (P =.422). Overall, no statistically significant difference in symptom relief was noted following external and endoscopic DCR for RAI NLDO as compared with PANDO.  

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Dohlman JC, Chiou CA, Boal NS, Yoon MK. Outcomes after external and endoscopic dacryocystorhinostomy in patients with radioactive iodine-associated nasolacrimal duct obstruction. Poster presented at: American Society of Ophthalmic Plastic and Reconstructive Surgery 52nd Annual Fall Scientific Symposium; November 11-12, 2021; New Orleans.