Global survey of lacrimal surgeons on practice of nasolacrimal duct obstruction amid COVID-19 pandemic

Authors

  • Chun Wah Lam Hong Kong Eye Hospital
  • Tessa Fayers Imperial College Healthcare NHS Trust
  • Hunter Kwok-lai Yuen Hong Kong Eye Hospital; The Chinese University of Hong Kong
  • Reynaldo Javate University of Santo Tomas Hospital
  • Jane Olver Clinica London

Keywords:

COVID-19, Lacrimal duct obstruction, Surveys and questionnaires

Abstract

Objective: To survey lacrimal surgeons worldwide on their practice of nasolacrimal duct obstruction amid the COVID-19 pandemic.

Methods: A 24-question survey was designed to investigate lacrimal surgeons worldwide on their practice of nasolacrimal duct obstruction before the COVID-19 outbreak, during the first wave of COVID-19 pandemic (Spring 2020), and during the study period (12 March 2021 to 12 May 2021). The survey was uploaded to a website, and the link of the survey was sent to international oculoplastic societies for further distribution to their members.

Results: A total of 570 respondents from 68 countries or regions were included in the analysis. During the study period, the preferred surgical technique for nasolacrimal duct obstruction was external dacryocystorhinostomy (DCR) [69.9%], followed by endoscopic DCR (46.0%). 95.1% of respondents performed silicone intubation. When the risk of COVID-19 infection was high, respondents preferred external DCR to endoscopic DCR. Respondents used higher levels of PPE for lacrimal irrigation and surgery during the study period than before the COVID-19 outbreak, in compliance with guidelines on aerosol-generating medical procedures.

Conclusions: Amid the COVID-19 pandemic, the preferred surgical treatment worldwide for nasolacrimal duct obstruction remains external DCR. The experience gained from the COVID-19 pandemic enables lacrimal surgeons to better prepare for future pandemics.

Author Biographies

Chun Wah Lam, Hong Kong Eye Hospital

Resident

Tessa Fayers, Imperial College Healthcare NHS Trust

Consultant ophthalmic surgeon, Department of Ophthalmology, Imperial College Healthcare NHS Trust

Hunter Kwok-lai Yuen, Hong Kong Eye Hospital; The Chinese University of Hong Kong

Deputy Hospital Chief Executive, Hong Kong Eye Hospital

Department of Ophthalmology and Visual Sciences, CUHK

Reynaldo Javate, University of Santo Tomas Hospital

University of Santo Tomas Hospital, Department of Ophthalmology, Manilla, Philippines

Jane Olver, Clinica London

Clinica London, Ophthalmology, London

References

Harrison AG, Lin T, Wang P. Mechanisms of SARS-CoV-2 transmission and pathogenesis. Trends Immunol 2020;41:1100-15.

Parasher A. COVID-19: Current understanding of its pathophysiology, clinical presentation and treatment. Postgrad Med J 2021;97:312-20.

Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020;323:1061-9.

World Health Organization. Coronavirus Disease (COVID-2019) Situation Reports. 2020. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed 13 March 2022.

Tang JW, Marr LC, Li Y, Dancer SJ. Covid-19 has redefined airborne transmission. BMJ 2021;373:n913.

World Health Organization. Available at: https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-covid-19-how-is-it-transmitted. Accessed 13 March 2022.

Workman AD, Jafari A, Welling DB, et al. Airborne aerosol generation during endonasal procedures in the era of COVID-19: risks and recommendations. Otolaryngol Head Neck Surg 2020;163:465-70.

Mick P, Murphy R. Aerosol-generating otolaryngology procedures and the need for enhanced PPE during the COVID-19 pandemic: a literature review. J Otolaryngol Head Neck Surg 2020;49:29.

Lammers MJW, Lea J, Westerberg BD. Guidance for otolaryngology health care workers performing aerosol generating medical procedures during the COVID-19 pandemic. J Otolaryngol Head Neck Surg 2020;49:36.

Tan L, Kovoor JG, Williamson P, et al. Personal protective equipment and evidence-based advice for surgical departments during COVID-19. ANZ J Surg 2020;90:1566-72.

Revised guidelines for potential aerosol-generating procedures (AGPs) within the ENT clinic. 2021. Available at: https://www.entuk.org/_userfiles/pages/files/covid19/revised_agp_guidelines.pdf

Ali MJ. COVID-19 pandemic and lacrimal practice: multipronged resumption strategies and getting back on our feet. Indian J Ophthalmol 2020;68:1292-9.

Mak ST, Yuen HK. Oculoplastic surgery practice during the COVID-19 novel coronavirus pandemic: experience sharing from Hong Kong. Orbit 2020;39:316-8.

Lanni V, Iuliano A, Laezza MP, Uccello G, Tranfa F, Strianese D. Oculoplastic management of patients in the Covid-19 era: experience from an Italian tertiary referral center. Orbit 2020;39:391-3.

Nair AG, Narayanan N, Ali MJ. A survey on the impact of COVID-19 on lacrimal surgery: the Asia-Pacific perspective. Clin Ophthalmol 2020;14:3789-99.

Nguyen AX, Gervasio KA, Wu AY. COVID-19 recommendations from ophthalmic and plastic reconstructive surgery societies worldwide. Ophthalmic Plast Reconstr Surg 2020;36:334-45.

Quaranta-Leoni FM, Paridaens D, Verity D. European Society of Ophthalmic Plastic and Reconstructive Surgery (ESOPRS) recommendations for oculoplastic surgeons during the COVID-19 pandemic: a challenge for the future. Orbit 2020;39:460-2.

American Academy of Ophthalmology. List of urgent and emergent ophthalmic procedures. Available at: https://www.aao.org/headline/list-of-urgent-emergent-ophthalmic-procedures OALouaeopAa.

Ali MJ, Hegde R, Nair AG, et al. All India Ophthalmological Society - Oculoplastics Association of India consensus statement on preferred practices in oculoplasty and lacrimal surgery during the COVID-19 pandemic. Indian J Ophthalmol 2020;68:974-80.

Nair AG, Gandhi RA, Natarajan S. Effect of COVID-19 related lockdown on ophthalmic practice and patient care in India: results of a survey. Indian J Ophthalmol 2020;68:725-30.

The World Bank. Available at: https://www.worldbank.org/en/home

Daigle P, Leung V, Yin V, Kalin-Hajdu E, Nijhawan N. Personal protective equipment (PPE) during the COVID-19 pandemic for oculofacial plastic and orbital surgery. Orbit 2021;40:281-6.

Barmettler A, Ehrlich JR, Lelli G Jr. Current preferences and reported success rates in dacryocystorhinostomy amongst ASOPRS members. Orbit 2013;32:20-6.

Nair AG, Kamal S, Agarwal A. Indian survey on practice patterns of lacrimal and eyelid disorders (iSUPPLE): report 2: mitomycin-C and lacrimal stents in dacryocystorhinostomy. J Craniofac Surg 2016;27:2015-9.

Gauba V, Islam T, Saleh GM, Zuberbuhler B, Vize C. The practice of dacryocystorhinostomy (DCR) surgery by ophthalmologists in the United Kingdom (UK). Orbit 2008;27:279-83.

Huang J, Malek J, Chin D, et al. Systematic review and meta-analysis on outcomes for endoscopic versus external dacryocystorhinostomy. Orbit 2014;33:81-90.

Kwok T, Ali MJ, Yuen H. Preferred practice patterns in endoscopic dacryocystorhinostomy among oculoplastic surgeons in Asia-Pacific region. Orbit 2018;37:248-53.

Sobel RK, Aakalu VK, Wladis EJ, Bilyk JR, Yen MT, Mawn LA. A comparison of endonasal dacryocystorhinostomy and external dacryocystorhinostomy: a report by the American Academy of Ophthalmology. Ophthalmology 2019;126:1580-5.

Hu Y, Chen T, Liu M, et al. Positive detection of SARS-CoV-2 combined HSV1 and HHV6B virus nucleic acid in tear and conjunctival secretions of a non-conjunctivitis COVID-19 patient with obstruction of common lacrimal duct. Acta Ophthalmol 2020;98:859-63.

Kang MG, Shim WS, Shin DK, Kim JY, Lee JE, Jung HJ. A systematic review of benefit of silicone intubation in endoscopic dacryocystorhinostomy. Clin Exp Otorhinolaryngol 2018;11:81-8.

Feng YF, Cai JQ, Zhang JY, Han XH. A meta-analysis of primary dacryocystorhinostomy with and without silicone intubation. Can J Ophthalmol 2011;46:521-7.

Fayers T, Dolman PJ. Bicanalicular silicone stents in endonasal dacryocystorhinostomy: results of a randomized clinical trial. Ophthalmology 2016;123:2255-9.

Downloads

Published

2022-12-29

How to Cite

1.
Lam CW, Fayers T, Yuen KL, Javate R, Olver J. Global survey of lacrimal surgeons on practice of nasolacrimal duct obstruction amid COVID-19 pandemic. Hong Kong J Ophthalmol [Internet]. 2022Dec.29 [cited 2024Mar.29];26(2). Available from: https://www.hkjo.hk/index.php/hkjo/article/view/335

Issue

Section

Original Articles

Most read articles by the same author(s)