The significance of primary monocanalicular silicone tube intubation in late surgical treatment in children

Abstract

Purpose: To evaluate the effect of monocanalicular silicone tube intubation outcomes as an initial surgical treatment in children older than 1 year old with primary nasolacrimal obstruction. Methods: Probing or monocanalicular silicone tube intubation was performed as primary surgical treatment on 12–48 months old children with primary nasolacrimal obstruction. Probing was performed on 53 eyes of 43 patients and silicone tube intubation on 45 eyes of 39 patients. Treatment was considered successful after improvement in patient complaints, the presence of normal tear meniscus, and normal results of fluorescein disappearance time test. Retrospective treatment success was compared between two groups according to age groups. Results: Treatment success was 79.1% in the probing group and 92.3% in the silicone tube intubation group. The success of the treatment was evaluated separately in the groups of 12 to <24 months, 24 to <36 months, and 36 to <48 months, and although the success level of the silicone tube intubation group was consistently found to be higher, the difference was not statistically significant. Treatment success decreased statistically significantly in the probing group with increased age of the patients, especially after 24 months. There was no such statistically significant decrease in the silicone tube intubation group. Conclusion: The choice of monocanalicular silicone tube intubation for primary surgical treatment in children with primary nasolacrimal obstruction provides success without the need for repetitive surgical interventions, especially in children older than 24 months.

Outcome of monocanalicular intubation for complex congenital nasolacrimal duct obstruction: the role of age

“…Considering the selfselection process and the accumulation of more cases of complex obstructions in older children, probing is insufficient to overcome the stenosis in the lacrimal pathways. Interestingly, some authors have noticed an age-related decline in the success of probing in CNLDO, without such a trend in those who underwent NLD intubation in their series [34,35].…”

“…There is some controversy in literature regarding the prognosis in older children with CNLDO. While some authors have reported decreased success in older children [18,[24][25][26][27][28][29][30][31][32], others have found similar outcomes in children of different ages [15,[33][34][35] and some have emphasized on the role of the type of obstruction (complex vs. simple), rather than the age per se [36][37][38][39].…”