Silicone intubation for nasolacrimal duct stenosis in adults: monocanalicular or bicanalicular intubation

• Published in: The Journal of craniofacial surgery Vol. 25; no. 3; pp. 1009 - 1011
• Main Authors: Andalib, Dima, Nabie, Reza, Abbasi, Leila
• Format: Journal Article
• Language: English
• Published: United States 01-05-2014
• Subjects: Adult; Aged; Dacryocystorhinostomy; Dentistry; Device Removal; Female; Humans; Intubation - instrumentation; Lacrimal Apparatus Diseases - surgery; Male; Middle Aged; Nasolacrimal Duct - surgery; Postoperative Complications - etiology; Reoperation; Silicones
• ISSN: 1049-2275; 1536-3732
• DOI: 10.1097/SCS.0000000000000708

The purpose of this study was to compare the success rate of monocanalicular versus that of bicanalicular silicone intubations of the nasolacrimal duct for nasolacrimal duct stenosis (NLDS) in adults (patent nasolacrimal duct with resistance to positive-pressure irrigation).
In a prospective randomized clinical trial, 52 eyes of 38 patients with NLDS underwent either monocanalicular silicone intubation (MCI) (n = 26 eyes) or bicanalicular silicon intubation (BCI) (n = 26 eyes). All procedures were performed by 1 oculoplastic surgeon. Tube removal was planned for 3 months postoperatively. Treatment success was defined as the complete resolution of epiphora or intermittent epiphora with normal dye disappearance test at 6 months after tube removal.
The surgical outcome was assessed in 25 eyes with MCI and 21 eyes with BCI. The mean (SD) age of treatment was 52.7 (18.6) years for MCI and 49 (18.8) years for BCI. Treatment success was achieved in 19 of 25 eyes (76%) in the MCI group compared with 16 of 21 eyes (76.2%) in the BCI group. Differences between the 2 groups proved to be not significant (P = 0.9). The only complication was peripunctal pyogenic granuloma in 2 eyes with BCI.
Both MCI and BCI were successful in a similar percentage of patients with NLDS. The main advantages of the former technique were simple insertion and easy removal of the tube.