{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:09:34Z","timestamp":1791821374960,"version":"4.3.4"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Purpose:<\/jats:title>\n To evaluate the efficacy of partial orbital lobe dacryoadenectomy (POLD) in patients with refractory epiphora.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Prospective interventional study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Tertiary eye care institute.<\/jats:p>\n <\/jats:sec>\n \n Study Population:<\/jats:title>\n Consecutive patients with refractory epiphora due to proximal lacrimal outflow system obstruction, multiple failed dacryocystorhinostomy, and postdacryocystectomy. All patients underwent preoperative assessment with Munk score, Schirmer-I Score, tear breakup time, corneal fluorescein staining, anterior segment OCT (AS-OCT), and CT scans of the orbit.<\/jats:p>\n <\/jats:sec>\n \n Intervention:<\/jats:title>\n Partial removal of the lacrimal gland orbital lobe under local anesthesia.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure:<\/jats:title>\n Reduction in epiphora. Objective and subjective evaluation was repeated at postoperative 1-week, 1-month, and 3-month visits.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Out of 17 patients enrolled, one had congenital punctal agenesis, three had acquired punctal effacement, and 13 had proximal bicanalicular obstruction. The mean age was 48.8 \u00b1 18.6 years. All patients underwent POLD, with removal of 50\u201360% of the orbital lobe of the lacrimal gland. The mean follow-up duration was 5.7 months. At 3-month follow-up visit, the average reduction in Munk score was 60%, the average reduction in Schirmer-I value was 35.2%, and the average reduction in tear film height on AS-OCT was 35.9% (all statistically significant,\n P<\/jats:italic>\n < 0.05), from the initial visit. None of the patients developed signs and symptoms of dry eye disease.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n POLD is an effective and safe procedure for patients with refractory epiphora in the short term. Further studies are needed to establish efficacy in the long term.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2055_25","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:00:09Z","timestamp":1779357609000},"page":"1373-1377","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Partial orbital lobe dacryoadenectomy for refractory epiphora"],"prefix":"10.4103","volume":"74","author":[{"given":"Neha","family":"Shree","sequence":"first","affiliation":[{"name":"Oculoplasty and Ocular Oncology Services, Dr. Shroff\u2019s Charity Eye Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obaidur","family":"Rehman","sequence":"additional","affiliation":[{"name":"Oculoplasty and Ocular Oncology Services, Dr. Shroff\u2019s Charity Eye Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chhavi Gupta","family":"Narula","sequence":"additional","affiliation":[{"name":"Oculoplasty and Ocular Oncology Services, Dr. Shroff\u2019s Charity Eye Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namita","family":"Kumari","sequence":"additional","affiliation":[{"name":"Oculoplasty and Ocular Oncology Services, Dr. Shroff\u2019s Charity Eye Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sima","family":"Das","sequence":"additional","affiliation":[{"name":"Oculoplasty and Ocular Oncology Services, Dr. Shroff\u2019s Charity Eye Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"R1-20260831","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1471-2415-15-6","article-title":"Korean society of ophthalmic plastic and reconstructive surgery (KSOPRS). Impact of epiphora on vision-related quality of life","volume":"15","author":"Shin","year":"2015","journal-title":"BMC Ophthalmol"},{"key":"R3-20260831","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1080\/01676830.2023.2204493","article-title":"Lacrimal gland targeted therapies for refractory epiphora: Quantitative changes in the gland activity","volume":"43","author":"Singh","year":"2024","journal-title":"Orbit"},{"key":"R4-20260831","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/eye.1991.3","article-title":"Jones\u2019 lacrimal canalicular bypass tubes: Twenty-five years\u2019 experience","volume":"5","author":"Rose","year":"1991","journal-title":"Eye (Lond)"},{"key":"R5-20260831","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1002\/alr.22668","article-title":"Conjunctivodacryocystorhinostomy (CDCR) success rates and complications in endoscopic vs non-endoscopic approaches: A systematic review","volume":"11","author":"Eisenbach","year":"2021","journal-title":"Int Forum Allergy Rhinol"},{"key":"R6-20260831","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1080\/01676830.2021.1966810","article-title":"Lacrimal gland botulinum toxin injection for epiphora management","volume":"41","author":"Jeffers","year":"2022","journal-title":"Orbit"},{"key":"R7-20260831","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1097\/IOP.0000000000002815","article-title":"Is orbital lobe of the lacrimal gland dispensable? Tear volume, ocular surface, and MRI volumetric analysis","volume":"41","author":"Singh","year":"2025","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R8-20260831","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.preteyeres.2009.04.003","article-title":"Neural regulation of lacrimal gland secretory processes: Relevance in dry eye diseases","volume":"28","author":"Dartt","year":"2009","journal-title":"Prog Retin Eye Res"},{"key":"R9-20260831","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1111\/j.1755-3768.1951.tb07628.x","article-title":"Keratoconjunctivitis sicca after partial extirpation of the palebral lacrimal gland","volume":"29","author":"Sj\u00f6gren","year":"1951","journal-title":"Acta Ophthalmol"},{"key":"R10-20260831","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/0002-9394(73)91156-2","article-title":"Palpebral dacryoadenectomy","volume":"75","author":"Taiara","year":"1973","journal-title":"Am J Ophthalmol"},{"key":"R11-20260831","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1097\/00002341-198804040-00005","article-title":"Palpebral dacryoadenectomy for epiphora","volume":"4","author":"Hornblass","year":"1988","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R12-20260831","doi-asserted-by":"crossref","first-page":"608","DOI":"10.3390\/medicina57060608","article-title":"Refractory dry eye syndrome after transconjunctival excision of the palpebral lobe of the lacrimal gland","volume":"57","author":"Lee","year":"2021","journal-title":"Medicina (Kaunas)"},{"key":"R13-20260831","first-page":"815","article-title":"Transient visual loss following palpebral dacryoadenectomy and intraorbital hemorrhage","volume":"13","author":"Hornblass","year":"1982","journal-title":"Ophthalmic Surg"},{"key":"R14-20260831","first-page":"3","article-title":"Surgical treatment for epiphora: Do not overlook the lacrimal gland","author":"Schwember","year":"2019","journal-title":"J Clin Cosmet Dermatol"},{"key":"R15-20260831","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.18240\/ijo.2021.12.07","article-title":"Clinical analysis of 109 cases of lacrimal gland pleomorphic adenoma","volume":"14","author":"Liu","year":"2021","journal-title":"Int J Ophthalmol"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2055_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T08:00:14Z","timestamp":1788163214000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2055_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_2055_25","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"assertion":[{"value":"2025-08-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-06","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}