Comparison of the efficacies of 1.0mm and 1.5mm silicone tubes for the treatment of nasolacrimal duct obstruction

This study was designed to compare the postoperative outcomes of bicanalicular intubation using different diameters of silicone tubes to treat post-saccal nasolacrimal duct obstruction. A total of 130 patients diagnosed with post-saccal obstruction who underwent endoscopic-assisted silicone tube intubation were included in the study. The patients were divided into two groups; those intubated with a 1.5-mm large diameter tube (Group LD) and those with a 1.0-mm normal diameter tube (Group ND). The patency rates of the two groups at one year after tube removal were compared using the Kaplan–Meier's curve and Restricted mean survival time (RMST) method with τ = 365 days. Results showed that the recurrence rate after tube removal was significantly lower in the LD group compared to the ND group (p = 0.001). The patency rates at one year after removal in the LD and ND group were 0.857 (0.754-0.919) and 0.739 (0.617-0.828), respectively. When comparing the patency rates by the RMST method at τ = 365 days, the RMST difference, RMST ratio, and RMTL ratio were higher in the LD group at p = 0.045, 0.052, and 0.046, respectively.

Comparison of the efficacies of 1.0mm and 1.5mm silicone tubes for the treatment of nasolacrimal duct obstruction

This study was designed to compare the postoperative outcomes of bicanalicular intubation using different diameters of silicone tubes to treat post-saccal nasolacrimal duct obstruction. A total of 130 patients diagnosed with post-saccal obstruction who underwent endoscopic-assisted silicone tube intubation were included in the study. The patients were divided into two groups; those intubated with a 1.5-mm large diameter tube (Group LD) and those with a 1.0-mm normal diameter tube (Group ND). The patency rates of the two groups at one year after tube removal were compared using the Kaplan–Meier's curve and Restricted mean survival time (RMST) method with τ = 365 days. Results showed that the recurrence rate after tube removal was significantly lower in the LD group compared to the ND group (p = 0.001). The patency rates at one year after removal in the LD and ND group were 0.857 (0.754-0.919) and 0.739 (0.617-0.828), respectively. When comparing the patency rates by the RMST method at τ = 365 days, the RMST difference, RMST ratio, and RMTL ratio were higher in the LD group at p = 0.045, 0.052, and 0.046, respectively.

Comparison of the efficacies of 1.0mm and 1.5mm silicone tubes for the treatment of nasolacrimal duct obstruction

This study was designed to compare the postoperative outcomes of bicanalicular intubation using different diameters of silicone tubes to treat post-saccal nasolacrimal duct obstruction. A total of 130 patients diagnosed with post-saccal obstruction who underwent endoscopic-assisted silicone tube intubation were included in the study. The patients were divided into two groups; those intubated with a 1.5-mm large diameter tube (Group LD) and those with a 1.0-mm normal diameter tube (Group ND). The patency rates of the two groups at one year after tube removal were compared using the Kaplan–Meier's curve and Restricted mean survival time (RMST) method with τ = 365 days. Results showed that the recurrence rate after tube removal was significantly lower in the LD group compared to the ND group (p = 0.001). The patency rates at one year after removal in the LD and ND group were 0.857 (0.754-0.919) and 0.739 (0.617-0.828), respectively. When comparing the patency rates by the RMST method at τ = 365 days, the RMST difference, RMST ratio, and RMTL ratio were significantly higher in the LD group at p = 0.045, 0.052, and 0.046, respectively.

Changes of Tears MCP-1 Level After External Dacryocystorhinostomy in Primary Acquired Nasolacrimal Duct Obstruction

Purpose: To define tears MCP-1 changes after uncomplicated external dacryocystorhinostomy with bicanalicular silicone tube intubation surgery.Methods: In this prospective, longitudinal study, we included patients diagnosed with primary acquired nasolacrimal duct obstruction and underwent dacryocystorhinostomy with bicanalicular silicone tube intubation surgery. Tears samples were collected with a Schirmer strip placed lateral conjunctival cul-de-sac and stored in Eppendorf tubes at -80°C. At the end of the study, they were taken out of the -80°C cabinet and brought to room temperature. The papers were cut into small pieces and incubated in 2 milliliters tubes with phosphate-buffered saline solution in a shaker at 100 revolutions per minute. Then they were centrifuged at 1.000 revolutions per minute for 5 minutes. MCP-1 levels were determined by using an ELISA kit. Results: Of the patients, 14 (56%) were female, and 11 (44%) were male. The mean age was 52.7±10.3 years (ranged from 30 to 63 years). The MCP-1 levels were 498.66±101.35 ng/L, 576.40±149.78 ng/L, 422.53±85.94 ng/L, 436.96±81.38 ng/L before surgery, in the first week, the first and third months after surgery, respectively. The mean MCP-1 level significantly increased in the first week compared to the preoperative level (p < 0.001). In the postoperative first month, there was a prominent decrease (p < 0.001). In the third postoperative month, the mean MCP-1 level was not significantly increased compared to the postoperative first month (p=0.196).Conclusion: The tears MCP-1 level was significantly decreased after uncomplicated external dacryocystorhinostomy with bicanalicular silicone tube intubation surgery

Surgical outcomes in acute dacryocystitis patients undergoing endonasal endoscopic dacryocystorhinostomy with or without silicone tube intubation

AIM: To establish the necessity of silicone tube intubation in acute dacryocystitis (AD) patients undergoing endonasal endoscopic dacryocystorhinostomy (En-DCR). METHODS: Patients presenting with unilateral AD were randomly assigned to two treatment groups. En-DCR procedures were performed following lacrimal abscess formation, with the operation being performed with silicone intubation for patients in group B but not group A. Functional success was defined by an absence of additional AD episodes, no epiphora, and ostium patency as established via endoscopic evaluation or fluorescein irrigation. Operative success rates and demographic variables were compared between treatment groups. RESULTS: In total, 66 patients were analyzed in the present study (33 per group), with complete postoperative data having been successfully collected from 27 and 22 patients in group A and group B, respectively. All patients exhibited complete resolution of acute inflammation. Upon follow-up, granulation tissue was detected around the ostium at higher rates in group B (9/22, 40.9%) relative to group A (4/27, 14.8%). At the 12-month follow-up time point, patients in group A exhibited higher success rates (25/27, 92.6%) relative to patients in group B (20/22, 90.9%), but this difference was not significant. Cases of lacrimal passage reconstruction failure in both groups were attributed to excessive fibrous and/or granulation tissue formation proximal to the intranasal ostium. CONCLUSION: Given that these two operative approaches are associated with similar rates of operative success and in light of differences in granulation tissue formation, cost, and operative duration, these data do not support the routine silicone intubation of AD patients following En-DCR surgery.

The significance of primary monocanalicular silicone tube intubation in late surgical treatment in children

Purpose: To evaluate the effect of monocanalicular silicone tube intubation outcomes as an initial surgical treatment in children older than 1 year old with primary nasolacrimal obstruction. Methods: Probing or monocanalicular silicone tube intubation was performed as primary surgical treatment on 12–48 months old children with primary nasolacrimal obstruction. Probing was performed on 53 eyes of 43 patients and silicone tube intubation on 45 eyes of 39 patients. Treatment was considered successful after improvement in patient complaints, the presence of normal tear meniscus, and normal results of fluorescein disappearance time test. Retrospective treatment success was compared between two groups according to age groups. Results: Treatment success was 79.1% in the probing group and 92.3% in the silicone tube intubation group. The success of the treatment was evaluated separately in the groups of 12 to <24 months, 24 to <36 months, and 36 to <48 months, and although the success level of the silicone tube intubation group was consistently found to be higher, the difference was not statistically significant. Treatment success decreased statistically significantly in the probing group with increased age of the patients, especially after 24 months. There was no such statistically significant decrease in the silicone tube intubation group. Conclusion: The choice of monocanalicular silicone tube intubation for primary surgical treatment in children with primary nasolacrimal obstruction provides success without the need for repetitive surgical interventions, especially in children older than 24 months.

CROSS SECTIONAL STUDY OF SUCCESS RATE OF EXTERNAL DACRYOCYSTORHINOSTOMY SURGERY WITH AND WITHOUT INTUBATION STENT USAGE IN A TERTIARY CARE HOSPITAL

Dacryocystorhinostomy is widely considered as the standard treatment due to chronic nasolacrimal duct obstruction (NLDO). These procedures include standard external Dacryocystorhinostomy (DCR), non-laser endonasal endoscopic DCR (EN-DCR), and endonasal endoscopic laser DCR (LA-DCR)1. However external DCR is considered as the gold standard surgical method in the treatment of NLDO. Our study describes a comparative study of success rates of external DCR surgery, wherein 30 patients each were included for with and without silicone tube intubation usage respectively. The results showed a higher success rate (90%) in outcome of external DCR surgery using silicone tube intubation as compared to that without its usage (80%). Therefore, this study was aimed to shed further light on EXDCR surgery using intubation stents. The study also helps in shedding light on better post-operative management and obtaining higher success rates in case of EX-DCR surgery.