Silicone Tube Intubation with Lacrimal Endoscopy and Endonasal Dacryocystorhinostomy in Adult Nasolacrimal Duct Obstruction

Abstract

Purpose: To compare the success rate of silicone tube intubation using a lacrimal endoscope with that of endonasal dacryocystorhinostomy in adult acquired nasolacrimal duct obstruction with no canalicular obstruction. Methods: Retrospective cross-sectional study including 21 patients (31 eyes) treated with silicone tube intubation using lacrimal micro-endoscope and 29 patients (37 eyes) who underwent endonasal dacryocystorhinostomy. We examined lacrimal irrigation, probing, and fluorescein dye disappearance before surgery. A total of 3 months after surgery, the silicone tube was removed. The success rates were determined based on symptoms and the results of lacrimal irrigation. Results: For silicone tube intubation in the lacrimal endoscopy group, success rates 3 and 6 months after surgery were 87.1% and 71.0%, respectively. In the endonasal dacryocystorhinostomy group, they were 91.9% and 81.1%, respectively. There was no significant difference in success rates 3 and 6 months after surgery (p = 0.517 and p = 0.327, respectively). However, a significantly higher success rate (81.8%) was observed in the endonasal dacryocystorhinostomy group compared with the silicone tube intubation using lacrimal micro-endoscope group (66.7%) at 6 months after surgery if the patient had total regurgitation upon preoperative examination of lacrimal irrigation (p = 0.028). Conclusions: There was no significant difference in success rates between silicone tube intubation using lacrimal endoscope and endonasal dacryocystorhinostomy in adult acquired nasolacrimal duct obstruction with no canalicular obstruction, although there was a lower success rate in patients with total nasolacrimal duct obstruction. Silicone tube intubation using lacrimal endoscope may reduce the frequencies and complications of unnecessary invasive operations and general anesthesia.