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Lee and Chang: A Modified Technique of Bicanalicular Silicone Tube Intubation in Congenital Nasolacrimal Duct Obstruction
Original Article

J Korean Ophthalmol Soc 2009;50(7):984-988.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.7.984

A Modified Technique of Bicanalicular Silicone Tube Intubation in Congenital Nasolacrimal Duct Obstruction

Tae Soo Lee, MD, PhD, Minwook Chang, MD

Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea

Address reprint requests to Tae Soo Lee, MD, PhD Department of Ophthalmology, Guro Hospital, Korea University College of Medicine #97 Gurodong-gil, Guro-gu, Seoul 152-703, Korea Tel: 82-2-2626-1277, Fax: 82-2-857-8580, E-mail: tsoooo@hanmail.net

Received 10 October 2008       Accepted 14 April 2009

Copyright © 2009 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To introduce a modified technique of bicanalicular silicone tube intubation, which can reduce slitting of the canaliculus and protrusion of the tube.

Methods

This study included 46 patients who underwent modified surgery for Congenital Nasolacrimal Duct (CNLD) obstruction. To be included in this study, patients were older than 13 months and had a history of failed probing. Using our modified technique, tube lengths can be appropriately adjusted by either pulling or releasing the tube at the medial canthus until a tube loop is in place without any tension to the upper and lower canaliculi. Two threads of silicone tube were tied together using 5–0 nylon over a silicone sponge (5×5 mm) and left within the nasal cavity for several months without fixation to the nasal mucosa. A successful surgery was clinically defined as no epiphora and no dye retention in the conjunctival sac.

Results

The mean age of patients at the time of surgery was 32.8 (±18.9) months. There were 22 males and 24 females. Prior to intubation, patients had been probed an average of 1.5 (±1.3) times, and the mean follow-up period was 12.6 (±14.2) months. The tube was removed at 5.4 (±1.3) months postoperatively on average. The success rates were 88%. Tube protrusions occurred in three eyes, and canalicular splittings were recorded in two eyes. No other serious complications were encountered.

Conclusions

This new technique might enable us to remarkably reduce both protrusion and slitting of the canaliculus in bicanalicular silicone intubation for congenital nasolacrimal duct obstruction.

Keywords: Canalicular laceration, Congenital NLD obstruction, Silicone tube intubation, Tube protrusion

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Figure 1.
Bicanalicular silicone tube is in place and silicone sponge is placed 2∼3 mm below the inferior meatus.
jkos-50-984f1.tif
Figure 2.
Schematic diagram shows that the ideal position of the silicone tube intubated in modified surgery is in place without tension and the silicone sponge is placed 2∼3 mm below the inferior meatus.
jkos-50-984f2.tif
Table 1.
Characteristics of the patients
Mean± SD Range
Age at surgery (months) 32.8±18.9 13∼96
Numbers of previous probing 1.5±1.3 1∼3
Follow up period (months) 12.6±14.2 1∼54
Timing of tube removal (months) 5.4±1.3 0.25∼6
Table 2.
Postoperative complications
No of patients (%)
Protrusions of tube 3 (6.2)
Slitting of canaliculus 2 (4.2)
Granuloma formations 3 (6.2)
Canaliculitis 1 (2.1)
Nasal bleeding 1 (2.1)
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