Nasolacrimal intubation in endoscopic transcanalicular dacryoplasty – a long-term analysis

Abstract

Purpose : Nowadays, transcanalicular endoscopic dacryoplasty represents the majority of lacrimal duct surgery procedures performed in adults in specialised centers. However, there are still hardly any data available regarding the intra- and postoperative care, particularly regarding the duration of tube intubation in these patients. Our aim was to evaluate the relation between tube duration and recurrence of symptoms in patients who underwent transcanalicular microdrill dacryoplasty (tMDP) in a long-term setting.

Methods : The medical records of 576 adult patients after tMDP were retrospectively reviewed and data on silicone tube intubation duration as well as on the recurrence of symptoms were extracted. In cases the information was not given in the medical record, the missing data were evaluated by a telephone survey. In this study, only the complete resolution of symptoms ("no epiphora") without subsequent dacryocystitis or any additional surgical intervention during the follow-up period was defined as success.

Results : A total of 256 eyes of 191 patients could be included in this study. The mean follow-up time was 7.5 ± 7.5 years. In 57.0 % of the cases there was still full resolution of symptoms at the time of the survey. The mean duration of the silicone tube intubation was 5.5 ± 7.8 months. When distinguishing between a tube duration < 3 months and ≥ 3 months there was a significant difference in the success rate (<3 months: 38 %; ≥ 3 months: 61 %; p = 0.01). A subgroup analysis of the groups of intubation duration from 3 to < 6 months and ≥ 6 months, however, showed no significant difference (p > 0.05).

Conclusions : Based on our results, the silicone tube intubation after transcanalicular MDP should be left in place for at least 3 months, as earlier removal seems to be associated with a higher incidence of recurrence of symptoms. Respecting the recommended intubation duration tMDP is a well-tolerated, minimally invasive procedure with satisfactory success rates.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.