Ritleng Intubation Set: A New System for Lacrimal Pathway Intubation

Abstract

Silicone tubing of the lacrimal pathway is used after lacrimal pathway injuries or canalicular stenosis. This procedure is often complicated by the so-called accordeon phenomenon. Far the last 3 years we have used a new system for lacrimal intubation: the Ritleng intubation set. It consists of a silcone tube which is connected to a polypropylene tube and a specially designed stainless probe for lacrimal insertion. Due to the smooth connection of the polypropylene tube and the silicone tube intubation can be performed easily and without the so-called accordeon phenomenon. In case of congenital or acquired lacrimal stenosis probing and silicone intubation can be performed in one step. We used this set in 19 lacrimal lacerations of the lacrimal pathway and in 7 cases of congenital and 12 cases of acquired lacrimal stenosis. With this specially designed lacrimal intubation set lacerated canaliculi can be quickly reapproximated. It allows probing of the lacrimal system and intubation in one procedure. In this report the technique and indications will be described and discussed.

Dacryoendoscopic surgery and tube insertion in patients with common canalicular obstruction and ductal stenosis as a frequent complication

“…In CCO, silicone intubation is also used in treatments involving laser canaliculoplasty 17 and external DCR with membranectomy, 18 and a variety of silicone intubation sets have been described. 12,14,15,[24][25][26] The probes have blunt tips to avoid submucosal penetration and injury to the lacrimal mucosa; however, blind insertion is required. We revealed that conventional methods of tube insertion have a high associated risk of submucosal penetration (20%), 12 and a quarter of CCO cases have severe ductal stenosis, which makes blind intubation diffi cult.…”

Investigating the Role of Metal Fatigue in a Case of Ritleng Probe Fracture

“…[3][4][5][6] Prior to this publication, what has not been reported is the potential for the device to break during intra-operative use on patients. To mitigate this complication, we discuss why this may have occurred and ways to prevent it in the future.…”

“…5 In 1996, Pierre Ritleng, a French specialist in oculoplastic and lacrimal surgery, first described a new system for nasolacrimal duct intubation developed to minimize mucosal injury. 6 The Ritleng probe (model S1-1470; manufactured by FCI Ophthalmics, Marshfield Hills, MA, U.S.A.) is a malleable, hollow, stainless steel tube with a diameter of 1 mm and a length of 105 mm. 5 The probe's superior end has a funnel-shaped entrance allowing easy introduction of the silicon stent's Prolene lead.…”

Silicone Intubation with or without Balloon Dacryocystoplasty in Acquired Partial Nasolacrimal Duct Obstruction

“…The two silicone tubes were tied together with a polypropylene 6-0 suture and was fixated to the lateral wall of the nose. 12 In group 2, bicanalicular silicone tube intubation, according to Ritleng, was performed directly after probing.…”