Evaluation of Functional Outcome of Silicone Intubation on Patency of Lacrimal System in Canalicular Obstruction and Revision Surgeries

Abstract

Purpose:- The purpose of the present study is to report authors’ experience of functional outcome of Silicone intubation on patency of lacrimal system in canalicular obstruction and revision surgeries. Materials and Methods:- This study was conducted at Sardar Patel Medical College from January 2015 to March 2017. A total of 32 cases were enrolled in this study. Twelve patients of canalicular block and 20 patients of various failed DCR techniques were recruited for the study. Two patients had failed DCR twice, and 18 patients had failed DCR once. Twelve of these previous failed DCR were endoscopic DCR, and 6 were external dacryocystorhinostomy (E-DCR). All cases were operated by a single surgeon using the same technique of intubation. Results:- In our study we found that Silicone intubation is an effective method for treating canalicular block and failed DCR. Silicone tube is soft, relatively inert, and flexible, causing minimal injury to the delicate canaliculi and nasal mucosa. It maintained duct patency by maintaining an opening. The main outcome measures were the resolution of epiphora and the anatomical and functional successes by patency on follow up. Conclusion:- The success rates reported for silicone intubation range from 69% to 100% in various studies. The 94.5% success rate noted in the present study is entirely comparable to these previously reported results, with minimal complication. duct obstruction. Despite meticulous surgery, failures are often met with. Epiphora after Dacryocystorhinostomy (DCR) is a distressing situation for both patient and the surgeon. Failure rate for external DCR has been reported to be 5%–10% 4-6 or less and 35%–40% 7-9 for endonasal DCR. The most common causes of DCR failure are common canalicular obstruction and obstruction at the rhinostomy site due to reduction in osteotomy size 2 , granulation tissue formation 3 , fibrosis in anastomosis and defective identification and anastomosis. Silicone intubation has been shown to be successful in the management of failed DCR and canalicular block. Silicone intubation is a simple procedure; the effectiveness of this procedure was assessed. A basic surgical principle is to reach the most successful results with the least possible complication. In the modern surgical era, achieving successful results in a cost effective fashion is also important. The aim of this study to evaluate the success rate of silicone intubation in canalicular block as primary surgery and in failed DCR as revised surgery. Abstract were enrolled in this study. These included 12 patients of canalicular block, that were operated for the first time and 20 patients of various failed DCR techniques. Two patients had failed DCR twice, and 18 patients had failed DCR once. 12 of these previous failed DCR were endoscopic DCR, and 6 were external dacryocystorhinostomy (DCR). The inclusion criteria for the procedures were patients having epiphora after previous surgery and common canalicular block. Exclusion criteria was patients having absent puncta, suspicion of malignancy, radiation therapy, posttraumatic lids and bony deformity, nasolacrimal duct block (not operated previously).