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. 2023 Apr;43(4):1127-1133.
doi: 10.1007/s10792-022-02510-3. Epub 2022 Sep 14.

Soft stop on syringing and probing may have a high false-positive rate in diagnosing pre-sac obstruction

Eiman Usmani #  1   2 , Yinon Shapira #  3   4 , Carmelo Macri  3   4 , Garry Davis  3   4 , Dinesh Selva  3   4
Affiliations

Soft stop on syringing and probing may have a high false-positive rate in diagnosing pre-sac obstruction

Eiman Usmani et al. Int Ophthalmol. 2023 Apr.

Abstract

Purpose: To determine the diagnostic value of 'soft stops' encountered during lacrimal syringing and probing.

Methods: Single-center retrospective review. Adult patients with epiphora attending a tertiary lacrimal clinic from May 2010 to April 2021 were reviewed. Cases with evidence of soft stop encountered during lacrimal syringing/probing were included, and patients with possible canaliculitis or a history of lacrimal surgery were excluded. Findings of syringing/probing consistent with pre-sac obstruction were correlated with dacryocystography (DCG) and surgical findings.

Results: 53 (10.2%) canalicular systems had soft stops on syringing/probing and were included in the analysis. The mean age of the patients was 63.8 ± 15.6 (range 28-87) years, and 27 (65.9%) were females. Intraoperative examination findings were available for 27 of 30 cases that underwent lacrimal surgery and DCG was available for 40 systems. Pre-sac obstruction found on syringing/probing was confirmed in 40% and 37% of cases on DCG and surgery, respectively. The correlation between syringing/probing and DCG was stronger for canalicular than for common canalicular location (p = 0.016). Canalicular stenosis on syringing/probing manifested as pre-sac abnormality on DCG in 5/7 (71.4%) compared to 0/6 common canalicular stenosis cases (p = 0.021). Based on the surgical findings, the false-positive rate of a soft stop on syringing/probing was highest for common canalicular 'stenosis' (100%) and lowest for canalicular 'block' (45.5%; p = 0.093). Findings of pre-sac obstructions on DCG were confirmed in 85.7% of the cases intraoperatively (p = 0.035 compared to syringing/probing alone).

Conclusions: Soft stops on probing showed poor correlation with DCG and surgical findings, particularly in common canalicular location.

Keywords: Canalicular block; Dacryocystography; Epiphora; Lacrimal probing; Lacrimal syringing; Soft stop.

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Conflict of interest statement

All authors declare there are no conflicts of interest or financial disclosures in relation to the work described.

Figures

Fig. 1
Fig. 1
Location and degree (stenosis or block) of pre-sac obstruction based on lacrimal syringing/probing in the clinic. NA obstruction location and/or degree not available
See this image and copyright information in PMC

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