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Park, Koo, Lee, Lee, and Kim: Comparison of Clinical Efficacy Between Tie Methods of Silicone Tube Intubation in Nasolacrimal Duct Obstruction
Original Article

J Korean Ophthalmol Soc 2009;50(2):177-181.

Published online: 3 August 2009

DOI: https://doi.org/10.3341/jkos.2009.50.2.177

Comparison of Clinical Efficacy Between Tie Methods of Silicone Tube Intubation in Nasolacrimal Duct Obstruction

Young Min Park, MD1, Gi Hong Koo, MD1, Ji-Eun Lee, MD1, Jong Soo Lee, MD1, Yoon Kyung Kim, PhD2

1Department of Ophthalmology, College of Medicine, Pusan National University, Pusan, Korea

2Department of Ophthalmic Optics, Kaya University, Kyungbuk, Korea

Address reprint requests to Jong Soo Lee, MD Department of Ophthalmology, Pusan National University Hospital #1-10 Ami-dong, Seo-gu, Pusan 602-739, Korea Tel: 82-51-240-7957, Fax: 82-51-242-7341, E-mail: jongsool@pusan.ac.kr

Received 23 April 2008       Accepted 19 August 2008

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 compare the clinical outcome of silicone tube intubation according to the tie methods.

Methods

Eighty-eight eyes of 87 patients who underwent silicone tube intubation were divided into two groups based on the tie method: a silicone silastic sheet group (Group 1, n=59) and a nylon 6-0 suture knot group (Group 2, n=29). The two groups were compared according to their success rates, recurrence rates and complications.

Results

No significant difference was found in the success rate between the two groups (83.0% in Group 1 and 82.7% in Group 2). However, Group 2 showed a significantly higher rate of postoperative complications than Group 1. In Group 1, 5/59 (8.4%) eyes had ocular irritation, 2/59 (3.4%) eyes exhibited tube prolapse, conjunctivitis, corneal erosion, and dacryocystitis and 1/69 (1.6%) eyes had a punctal slit after intubation. In Group 2, 3/29 (10.3%) eyes had ocular irritation, 2/29 (6.9%) eyes exhibited tube prolapse, conjunctivitis, a punctal slit, and dacryocystitis, and 1/29 (3.4%) eyes showed corneal erosion, or a granuloma after intubation. A recurrence of symptomatic tearing was found in 6/59 (10%) eyes in Group 1 and 3/29 (10%) in Group 2.

Conclusions

In silicone tube intubation of incomplete NLD obstruction, the usage of silicone silastic sheets to tie both ends of the silicone tube produced a lower complication rate and a higher success rate than that of the suture knot group. Lower tension on the nasolacrimal passage in the silicone silastic sheet group allows for a significantly lower rate of punctal slit development. Therefore, the method of using silicone silasitic sheets can be considered useful in the treatment of NLD obstruction.

Keywords: Nasolacrimal duct obstruction, Silicone silastic sheet, Tie method

References

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Figure 1.
A tie made at the silicone silastic sheet by using silicone tube (A), and a tie made by Nylon 6-0 (B).
jkos-50-177f1.tif
Table 1.
Clinical Characteristics
Groups Group 1 Group 2 p-value
Age 46.3 (15-75) years 46.0 (21-61) years >0.05†
Male : Female 19 : 40 eyes 8 : 21 eyes >0.05*
Symptom duration 12 (1.0-120) months 11 (1.0-36) months >0.05†
Tube removal 4.6 (1.0-12.0) months 5.1 (2.5-8.0) months >0.05†
Success rate 49/59 (83.1%) 24/29 (82.7%) >0.05*

* Fisher’s exact test;

† paired t test.

Table 2.
The Rate and the type of postoperative complications after Silicone tube intubation using silastic sheet or suture knot group in NLD obstructed patients
Group 1 No. of eyes (%) Group 2 No. of eyes (%) ) P value*
Ocular Irritation 5 (8.4%) 3 (10.3%) > 0.05
Punctal slit 1 (1.6%) 2 (6.9%) 0.03
Tube prolapse 2 (3.4%) 2 (6.9%) > 0.05
Granuloma 0 1 (3.4%) > 0.05
Conjunctivitis 2 (3.4%) 2 (6.9%) > 0.05
Corneal erosion 2 (3.4%) 1 (3.4%) > 0.05
Inflammation of lacrimal passage 2 (3.4%) 2 (6.9%) > 0.05
Total 14/59 (23.7%) 13/29 (37.9%) 0.04

* Fisher’s exact test.

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