Long-term Outcome and Predictors of Silicone Tube Intubation for Patients with Nasolacrimal Duct Obstruction

Abstract

Purpose: To evaluate the long-term outcome and prognostic factors according to the degree of obstruction after silicone tube intubation in patients with nasolacrimal duct obstruction (NLDO).Methods: From March 2016 to July 2020, the medical records of 145 eyes of 107 patients with NLDO who underwent silicone tube intubation and had been followed for more than 6 months were analyzed retrospectively. The preoperative lacrimal irrigation and degree of obstruction were classified into three groups, and the surgery outcome was also evaluated. Successful surgery was defined as a case in which the epiphora improved, the height of the tear meniscus decreased, and there was no reflux in the postoperative lacrimal irrigation. Risk factors for recurrence were analyzed using a Cox proportional hazards model and Kaplan-Meier survival analysis.Results: Surgery was successful in 99 eyes (68.3%), while recurrence occurred in 46 eyes (31.7%) after silicone tube removal. The average follow-up period was 23.09 months. The recurrence rate was 30.4%, 29.3%, and 50.0% for functional, partial, and total NLDO, respectively, and did not differ significantly (p = 0.300). The risk of recurrence was higher at older age (adjusted hazard ratio [aHR] = 1.079, p < 0.001) and with a history of facial palsy (aHR = 4.031, p = 0.019), and was lower in the functional NLDO group than in the total NLDO group (aHR = 0.368, p = 0.040). In the Kaplan–Meier survival analysis, the total NLDO group differed significantly from the functional NLDO group (log-rank, p = 0.011).Conclusions: Age, a history of facial palsy, and the degree of preoperative obstruction were associated with the prediction of recurrence after silicone tube intubation in patients with NLDO.

Dacryoendoscopic Findings in the Failed Silicone Tube Intubations without Dacryoendoscopy

“…Recently, studies on long-term results after surgery are being conducted gradually. According to Koh et al [12], the conventional silicone tube intubation success rate was 68.3% and the factors affecting the surgical success rate were the elderly of a history of facial palsy and the risk of recurrence was lower in functional nasolacrimal duct obstruction than in complete nasolacrimal duct obstruction.…”