Journal List > J Korean Ophthalmol Soc > v.52(2) > 1008921

Park, Ha, and Lew: Factors Affecting the Long-term Outcome of Silicone Tube Intubation in Patients With Nasolacrimal Duct Obstruction

Abstract

Purpose

To evaluate factors affecting the outcome of silicone tube intubation in patients with nasolacrimal duct obstruction.

Methods

A retrospective study of the outcome of silicone tube intubation performed from August 2001 to August 2009 in 98 patients (132 eyes) with nasolacrimal duct obstruction was conducted. Improvement was defined as the disappearance of epiphora after silicone tube intubation and success was defined as maintenance of improvement by the time of the final patient followup. Recurrence was also defined as appearance of epiphora after silicone tube extubation.

Results

The success rate was 76.5% (101 eyes), failure rate was 8.3% (11 eyes), and recurrence rate was 15.2% (20 eyes). Preoperative canaliculus irrigation test was significantly correlated with symptomatic improvement and recurrence after silicone tube intubation (p = 0.003 and 0.045, respectively). The mean time that patients experienced recurrence was 43.7 months after silicone tube intubation, according to Kaplan-Meier survival analysis.

Conclusions

Preoperative canaliculus irrigation test is a simple and effective tool to estimate the outcome of silicone tube intubation. This outcome should be considered in the stage of planning treatment in nasolacrimal duct obstruction patients.

References

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Figure 1.
Kaplan-Meier survival plot for long term success after silicone tube intubation. Arrow suggests minimum follow up period (36 months) for the 50% success rate after silicone tube intubation.
jkos-52-129f1.tif
Table 1.
Demographic features
Factors  
Age (yr) 53.8 ± 12.8
Sex  
 Male 29 (29.6%)
 Female 69 (70.4%)
Laterality  
 OD 66 (50.0%)
 OS 66 (50.0%)
Duration of symptom (yr) 3.6 ± 4.4
Follow up duration (mon) 12.8 ± 12.2
Time of extubation (mon) 5.4 ± 1.7
Improvement 121 eye (91.7%)
 Success rate 101 eye (76.6%)
 Recurrence rate 20 eye (15.1%)
Failure 11 (8.3%)

Success was defined as resolution of epiphora and ‘pass’ at the canaliculus irrigation test at the final followup point;

Recurrence was defined as occurrence of epiphora after slilicone tube extubation.

Table 2.
Characteristics in patients with improvement after silicone tube intubation
Factors Improvement (n = 121) Failure (n = 11) p-value
Sex     0.079
 Male 35 (28.9%) 6 (54.5%)  
 Female 86 (71.1%) 5 (45.5%)  
Age (yr) 53.7 ± 12.2 56.2 ± 18.0 0.605
Laterality     0.753
 OD 60 (49.6%) 6 (54.5%)  
 OS 61 (50.4%) 5 (45.5%)  
Trephination 13 (10.7%) 1 (9.1%) 0.865
Duration of symptom (yr) 3.9 ± 4.8 2.3 ± 2.1 0.054

Improvement was defined as resolution of epiphora and ‘pass’ at the canaliculus irrigation test after silicone tube intubation;

Pearson chi-square test;

Independent t-test.

Table 3.
Improvement or failure and success or recurrence after silicone tube intubation according to preoperative dacryocysto-graphic findings
Degree of obstruction Improvement (Success/Recurrence) n = 121 (101/20) Failure (n = 11) p-value
Complete obstruction 11 (10/1) 3 0.017 (0.445)
Partial obstruction 105 (86/19) 6  
Normal 5 (5/0) 2  
Total 121 (101/20) 11  
Level of obstruction Improvement (Success/Recurrence) (n = 121) (101/20) Failure (n = 11) p-value
Lacrimal sac 16 (15/1) 2 0.232 (0.218)
Upper nasolacrimal duct 57 (49/8) 6  
Lower nasolacrimal duct 48 (37/11) 3  
Total 121 (101/20) 11  

Pearson chi-square test.

Table 4.
Improvement or failure and success tion test or recurrence after silicone tube intuba tion according to preope erative canaliculus irriga-
Canaliculus irrigation test Improvement (Success/Recurrence) n = 121 (101/20) Failure (n = 11) p-value
Not passed with regurgitation 31 (22/9) 8 0.003 (0.045)
Partial passed with regurgitation 51 (44/7) 3  
Well passed without regurgitation 39 (35/4) 0  

Pearson chi-square test.

Table 5.
Clinical factors in the patients with success group compared with recurrence group after silicone tube intubation
Factors Success (n = 101) Recurrence (n = 20) p-value
Sex     0.672
 Male 30 (29.7%) 5 (25.0%)  
 Female 71 (70.3%) 15 (75.0%)  
Age (yr, mean ± SD) 52.8 ± 12.2 55.9 ± 12.1 0.295
Laterality     0.348
 OD 52 (51.5%) 8 (40.0%)  
 OS 49 (48.5%) 12 (60.0%)  
Trephination 10 (9.9%) 3 (15.0%) 0.501
Duration of symptom (yr, mean ± SD) 3.7 ± 4.5 4.5 ± 6.1 0.488
Follow up duration (mon, mean ± SD) 13.1 ± 13.2 13.6 ± 9.1 0.844
Time of extubation (mon, mean ± SD) 5.5 ± 1.6 4.8 ± 1.7 0.069

Pearson chi-square test;

Independent t-test.

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