Abstract
Purpose :
To compare Nunchaku or Crawford stent placement during probing for the treatment of congenital or acquired nasolacrimal duct obstruction.
Methods :
A retrospective chart analysis was undertaken for patients that underwent lacrimal stenting with Nunchaku-style tubes (19 patients, 27 eyes) and Crawford tube placement (37 patients, 40 eyes) at the same institution from 2017-2018 by one of two oculoplastic surgeons. With the exception of lacrimal balloon dilation, cases performed in conjunction with other surgical procedures, such as ectropion repair or dacryocystorhinostomy (DCR), were excluded. The primary outcome measure was resolution of daily epiphora.
Results :
Outcomes were recorded in the early (<1 month) or late (1-3 months) post-operative period or long-term (>3 months) follow-up (Table 1). In the early post-operative period, the Nunchaku cohort 15 eyes (57.7%) had resolution of epiphora (9 ± 5.2 days) compared to 21 eyes (75.0%) of those that received a Crawford stent reported achieving success at 17.2 ± 7.6 days (p=0.18). In the late post-operative period, average time of follow-up for the Nunchaku cohort was 46.5 ± 10.5 days with 14 eyes (87.5%) reporting success compared to 61.3 ± 19.3 days with 3 eyes (75%) achieving success (p=0.51). In long-term follow-up, average duration was 118.4 ± 18.4 days with 5 eyes (100%) achieving success compared to average duration of 336.9 ± 241.2 days with 14 eyes (87.5%) reporting success (p=0.99).
We also analyzed success rates for patients receiving stents for congenital and acquired NLDO (Table 2). Average age of patients receiving Nunchaku stent for congenital NLDO was 3.5 ± 3.2 years compared to 70.6 ± 11.8 for acquired NLDO. For the Crawford stents, average age for congenital NLDO 2.1 ± 1 years and 53.7 ± 12.3 years for acquired NLDO. Success rates at every post-operative interval for both congenital and acquired NLDO was comparable between Nunchaku and Crawford stents.
Conclusions :
The short and long-term follow-up visits demonstrated comparable rates of improvement in epiphora for both the Crawford and Nunchaku style lacrimal stents. The Nunchaku lacrimal stent is a “push-style” stent that does not require intranasal retrieval or tying/securing of the distal ends of the tubes. In instances where the Nunchaku style stent is appropriately utilized, there may be benefits of improved surgical efficiency.
This is a 2021 ARVO Annual Meeting abstract.