{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:34:01Z","timestamp":1787758441537,"version":"build-2784847793"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To determine the diagnostic accuracy of manual regurgitation on pressure over the lacrimal sac (ROPLAS) versus lacrimal irrigation for screening nasolacrimal duct obstruction (NLDO) in adults prior to intraocular surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This cross-sectional study took place in a tertiary eye care hospital in South Tamil Nadu, India. From January to December 2017 and included consecutive patients who presented for routine cataract surgery. Prospective data collection occurred in 8369 eyes of patients who underwent cataract surgery. All patients underwent ROPLAS testing by an ophthalmologist followed by lacrimal irrigation by trained ophthalmic assistants, rechecked or confirmed in equivocal cases by ophthalmologists who were masked to the ROPLAS status. The primary outcome, the sensitivity, specificity, positive, and negative predictive values to detect lacrimal occlusion by ROPLAS compared with lacrimal irrigation with 95% confidence intervals was estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 8369 eyes underwent cataract surgery during the time periods of the study. ROPLAS and lacrimal irrigation were performed in all eyes. The sensitivity of ROPLAS to diagnose NLDO correctly was 54.5% (95% CI, 44.8%\u201363.9%) and its specificity was 100% (95% CI, 100%\u2013100%). The positive and negative predictive values were 75.3% (95% CI, 65.6%-83.0%) and 99.4% (95% CI, 99.2%\u201399.5%), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We found that ROPLAS when used alone had very low sensitivity and low positive predictive value in detecting NLDO prior to cataract surgery as compared with lacrimal irrigation. Hence, we recommend performing ROPLAS and lacrimal irrigation in every patient as part of the routine preoperative workup prior to cataract surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1722_22","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T10:52:06Z","timestamp":1667213526000},"page":"3833-3836","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Regurgitation on pressure over the lacrimal sac versus lacrimal irrigation in determining lacrimal obstruction prior to intraocular surgeries"],"prefix":"10.4103","volume":"70","author":[{"given":"Usha","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok","family":"Vardhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipankar","family":"Datta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirtha","family":"Mekhala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanda","family":"Kishore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunjan","family":"Rathi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P Lloyd","family":"Hildebrand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-22-20240828","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/ceo.12244","article-title":"Nasolacrimal duct screening to minimize post-cataract surgery endophthalmitis","volume":"42","author":"Kam","year":"2014","journal-title":"Clin Exp Ophthalmol"},{"key":"R2-22-20240828","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/00061198-199502000-00005","article-title":"Delayed-onset pneumococcal endophthalmitis after mitomycin-C trabeculectomy:Association with cryptic nasolacrimal obstruction","volume":"4","author":"Sidoti","year":"1995","journal-title":"J Glaucoma"},{"key":"R3-22-20240828","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S0002-9394(14)71744-1","article-title":"Pneumococcal endophthalmitis associated with nasolacrimal obstruction","volume":"116","author":"Lopez","year":"1993","journal-title":"Am J Ophthalmol"},{"key":"R4-22-20240828","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12886-017-0410-x","article-title":"Bacteriology of the conjunctiva in pre-cataract surgery patients with occluded nasolacrimal ducts and the operation outcomes in Japanese patients","volume":"17","author":"Hayashi","year":"2017","journal-title":"BMC Ophthalmol"},{"key":"R5-22-20240828","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1016\/S0161-6420(97)30013-X","article-title":"Clinical and radiologic lacrimal testing in patients with epiphora","volume":"104","author":"Guzek","year":"1997","journal-title":"Ophthalmology"},{"key":"R6-22-20240828","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.sjopt.2017.05.018","article-title":"Indian survey on practice patterns of lacrimal and eyelid disorders (iSUPPLE):Report 3-Cataract and nasolacrimal duct obstruction","volume":"31","author":"Nair","year":"2017","journal-title":"Saudi J Ophthalmol"},{"key":"R7-22-20240828","doi-asserted-by":"crossref","first-page":"2319","DOI":"10.1016\/S0161-6420(99)90533-X","article-title":"The Micro-Reflux Test:A new test to evaluate nasolacrimal duct obstruction","volume":"106","author":"Camara","year":"1999","journal-title":"Ophthalmology"},{"key":"R8-22-20240828","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1038\/eye.1998.47","article-title":"Comparison between nasolacrimal syringing\/probing, macrodacryo-cystography and surgical findings in the management of epiphora","volume":"12","author":"Irfan","year":"1998","journal-title":"Eye (Lond"},{"key":"R9-22-20240828","first-page":"211","article-title":"Evaluation of the role of syringing prior to cataract surgery","volume":"45","author":"Thomas","year":"1997","journal-title":"Indian J Ophthalmol"},{"key":"R11-22-20240828","doi-asserted-by":"crossref","first-page":"217","DOI":"10.4103\/SJOPT.SJOPT_87_21","article-title":"Self-regurgitation on pressure over lacrimal sac in cases of primary-acquired nasolacrimal duct obstruction:Correlation with physician examination and patients'perceptions","volume":"35","author":"Alam","year":"2021","journal-title":"Saudi J Ophthalmol"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_1722_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:13:46Z","timestamp":1787757226000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_1722_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":10,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_1722_22","relation":{},"ISSN":["0301-4738"],"issn-type":[{"value":"0301-4738","type":"print"}],"subject":[],"published":{"date-parts":[[2022,11]]}}}