Abstract
Purpose :
Bicanalicular stenting for congenital nasolacrimal duct obstruction (NLDO) often requires use of the operative room (OR) for removal. This study introduces a method for Crawford bicanalicular stent placement by looping the ends to themselves which are tied together with dissolvable sutures to ease in-office removal.
Methods :
This is a single institution, retrospective study that evaluates outcomes of patients aged 5 or under who underwent bicanalicular stenting for congenital NLDO by a single surgeon between 2004 and 2020. It was IRB approved. Only primary surgeries were included in the analysis. Stenting could be accompanied by balloon dilatation and/or turbinate infracture. Age, sex, follow-up time, complications, type of intervention, extrusion, recurrence, and OR removal were recorded.
Results :
This study included 56 eyes from 54 patients with a mean age of 19.0 ± 9.5 months (range, 8-50 months). In patients with bilateral procedures, only right eyes were analyzed unless there was a complication or recurrence in the left eye, in which case it was added. There was a 30.3% extrusion rate, a 5.4% rate of recurrence of disease, and a 3.6% rate of operative room removal. The average follow-up time was 25.1 ± 39.8 months (median, 4.1 months, range, 1-132 months). For patients with or without extrusion, there were no statistically significant differences between age, sex, laterality, type of intervention, follow-up time, or rate of recurrence. Each eye that had recurrence (3 total) or needed OR removal (2 total) underwent only bicanalicular stenting without accompanying procedures, although the difference in rates between procedures was also not statistically significant.
Conclusions :
This method had a low recurrence and OR removal rate, with similar extrusion and complication rates to other bicanalicular stent and intubation methods for the treatment of congenital NLDO. This procedure can be particularly useful in uncooperative patients or when attempting to avoid increased operative time.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.