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Purpose: To assess the anatomical and functional outcomes in patients who underwent surgery for canalicular laceration and did not experience significant epiphora, and to compare these outcomes with contralateral uninjured eye. Method: Dacryoscintigraphy, anterior segment optical coherence tomography (OCT), MUNK scores, and a satisfaction questionnaire were administered to 24 patients who had canalicular laceration repair without significant epiphora and had a minimum of 6 months of follow-up. Tear meniscus height (TMH), depth (TMD), and area (TMA) were measured using anterior segment OCT and compared with the values in the uninjured eye. Results: Sixteen patients (67 %) had lower, 7 (29 %) had upper canaliculus, and one (4 %) had lacerations in both canaliculi. Five patients (20.83 %) had concomitant orbital fractures, and three patients (12.5 %) underwent additional repair for corneoscleral laceration. Bicanalicular silicone tube intubation was performed in one patient, while Mini-Monoka stent intubation was used for all other patients. The mean follow-up period was 41 ± 22.3 months, and the mean interval between trauma and surgery was 30.2 ± 29 h. The mean duration until tube removal was 3 ± 2.54 months. The MUNK score was 1 in eight patients (33 %) and 0 in sixteen patients (67 %). Canalicular lacerations occurred due to home accidents in 8 patients, work accidents in 4, assaults in 5, and traffic accidents in 7.Dacryoscintigraphy showed drainage of tracer into the nasal cavity in dynamic imaging for 12 patients. Five patients had retention in the sac, four had prolonged and reduced drainage, one had reduced drainage, and two showed no drainage in the first and second hour images. In the operated eye, the mean tear meniscus height (TMH) was 279.6 µm, depth (TMD) was 215 µm, and area (TMA) was 28.9 µm². In the healthy eye, the mean TMH was 221.5 µm, TMD was 152.5 µm, and TMA was 15.3 µm². The anterior segment OCT values for the affected eye were statistically significantly higher than those for the healthy eye (p = 0.044 for TMH, p = 0.003 for TMD, p = 0.006 for TMA). TMD and TMA were statistically significantly higher in patients with a MUNK score of 1 (p = 0.019 for TMD, p = 0.05 for TMA). Abnormal dacryoscintigraphy results were more common in patients with globe injuries requiring additional surgery. Conclusion: Although patients did not report epiphora after canalicular laceration repair, our observations indicated potential functional and anatomical differences in dacryoscintigraphy and anterior segment OCT compared to their healthy eyes. We believe that close follow-up is crucial to identify and address any issues that may arise in the future following surgery.

Abstract Background Radioactive iodine 131 (I-131) is used in the treatment of differentiated thyroid cancer after thyroidectomy; however, its accumulation in non-thyroidal regions may give false positive results on iodine whole body scan (WBS). Only a few cases of radioiodine uptake in the orbital region in patients with thyroid cancer have been reported, which could be due to metastasis or false positive causes resulting from contamination or inflammatory etiology. Case presentation We describe a case of 49-year-old male with history of papillary thyroid carcinoma. The follow-up I-131 whole body scan showed a focus of increased radiotracer uptake in the region of left orbit. Correlative single photon emission computed tomography (SPECT-CT) showed that uptake was due to stenosis of the left nasolacrimal duct causing obstructive symptoms on left side. Dacryoscintigraphy also demonstrated significant obstruction of left nasolacrimal system. Conclusions The nasolacrimal duct obstruction is a rare adverse event after I-131 therapy that can result in an accumulation of radioiodine on whole body scan, mimicking metastasis. The use of additional spot views and SPECT-CT images along with thyroglobulin levels can help physicians in clarifying the situation in these uncertain cases.

Purpose: The purpose of the study was to evaluate the functional success rates using dacryoscintigraphy (DSG) after transcanalicular diode laser dacryocystorhinostomy (TDL-DCR). Methods: In this retrospective study, we investigated the records of 56 patients who underwent TDL-DCR for unilateral primary acquired nasolacrimal duct obstruction and anatomic patency was achieved. The lacrimal drainage systems of the other eyes of the patients were normal and were selected as control group. The functional success was evaluated with tear transit time (TT) on DSG and epiphora complaints' score (ECS) at postoperative 6 months. Results: Twenty-two (39%) of the patients were male and 34 (61%) were female, with a mean age of 46.6 (21–64). The dacryoscintigraphic findings of the operated and healthy eyes showed that there was statistically insignificant prolongation in the tear TT at the operated side at postoperative 6th month (P > 0.05). The mean ECS of operated eyes was 0.89. Functional success was achieved in 43 (76.8%) patients when the ECS of 0 and 1 was accepted as successful. A statistically significant delay in drainage was observed in DSG in all of the cases with epiphora score of 2 and 3 (P < 0.05). The tear TT was prolonged with the age increase (P < 0.05), but there was no significant difference concerning the gender. Conclusion: DSG is an effective tool to evaluate the functional success of TDL-DCR.