In this Journal Club episode of T.O.P., The Oculofacial podcast, host Dr. Seanna Grob welcomes three distinguished guests to discuss pivotal research articles from the 2023 November/December issue of OPRs.

• Dr. Anne Barmettler is an esteemed Associate Professor of Ophthalmology and the Director of the Oculoplastic Service at Albert Einstein College of Medicine in Montefiore Medical Center, New York. She is recognized for her extensive knowledge and specialization in ophthalmic plastic and reconstructive surgery, and she lends her expertise as a member of the editorial board for OPRS.
• Dr. Grace Lee serves as an Associate Professor of Ophthalmology and an accomplished oculoplastic surgeon at Harvard Medical School and Massachusetts Eye and Ear. Her rich experience and scholarly work are pivotal in the advancement of her field.
• Dr. Pete Setabutr is a Professor of Ophthalmology and the Director of the Oculoplastic Service at the University of Illinois College of Medicine and Illinois Eye and Ear Infirmary. He is also the Vice Chair of Global Ophthalmology and a valuable contributor to the editorial board for OPRS.

The episode delves into potential novel surgical techniques in patients with epiphora and addresses perioperative considerations in overweight and obese patients as well as outcomes of primary monocanalicular stent placement in pediatric patients with Down Syndrome and nasolacrimal duct obstruction.

The conversation begins with an intriguing exploration of an alternative to dacryocystorhinostomy, Nasolacrimal Duct Coronary Stent Recanalization (NCR), and its potential to utilize the physiologic anatomy for treating nasolacrimal duct obstructions. Additionally, the episode sheds light on the complexities of managing overweight and obese patients in oculofacial plastic surgery, encompassing perioperative risks and specialized care protocols. The third segment is a retrospective look at the success rates of primary monocanalicular stent placement in pediatric patients with Down Syndrome versus those without, highlighting varied outcomes and the quest for optimal treatments in such clinical scenarios.

Key Takeaways:

• New techniques like Nasolacrimal Duct Coronary Stent Recanalization (NCR) are being investigated as potential alternatives to traditional dacryocystorhinostomy.
• Managing oculofacial surgery in overweight and obese patients presents unique challenges, including the likelihood of extended operative times and postoperative wound healing difficulties.
• Pediatric oculoplastic surgery may require bespoke approaches, especially in children with Down Syndrome, where success rates for primary monocanalicular stent placement are significantly lower than in non-Down Syndrome patients.
• Bicanalicular stent placement with suture tying as a new method to potentially reduce operative room removal is discussed.
• The conversations in this podcast provide rich, practice-changing insights that could influence oculoplastic surgeons' approach to diverse patient groups.

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