Factors Affecting the Outcome of Silicone Intubation for Congenital Nasolacrimal Duct Obstruction

Jihyun Park; Yong Ju Lee; Sung Joo Kim; Jae Woo Jang

doi:10.3341/jkos.2011.52.3.266

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Park, Lee, Kim, and Jang: Factors Affecting the Outcome of Silicone Intubation for Congenital Nasolacrimal Duct Obstruction

Original Article

J Korean Ophthalmol Soc 2011;52(3):266-271.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.3.266

Factors Affecting the Outcome of Silicone Intubation for Congenital Nasolacrimal Duct Obstruction

Jihyun Park, MD, Yong Ju Lee, MD, Sung Joo Kim, MD, PhD, Jae Woo Jang, MD, PhD

Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea

Address reprint requests to Jae Woo Jang, MD, PhD Kim's Eye Hospital, Konyang University College of Medicine #156 Yeongdeungpo 4-ga, Yeongdeungpo-gu, Seoul 150-034, Korea Tel: 82-2-2639-7777, Fax: 82-2-2677-9214, E-mail: jjw@kimeye.com

Received 13 April 201016 September 2010 Accepted 17 January 2011

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 determine the factors affecting the outcome of silicone intubation for congenital nasolacrimal duct obstruction.

Methods

A total of 233 eyes of 200 children that received silicone intubation were enrolled in a retrospective study.

Results

The overall success of silicone intubation was 193 of 233 eyes (82.8%). There was no significant difference in success rate between age groups. Tube retention time did not affect the success rates. Immediate tube dislocation as early as within 2 weeks did not lower the success rates (81.5%). Success rates were significantly lowered by persistent epiphora at the point of tube removal (p < 0.001).

Conclusions

The outcome of silicone intubation is determined by symptomatic improvement, which is not affected by tube retention time. Unplanned early tube dislocation may not affect the outcome of silicone intubation unless symptoms are persistent, and sufficient tube retention time does not ensure the success if symptoms are persistent.

Keywords: Congenital nasolacrimal duct obstruction, Success rate, Tube retention time

References

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Figure 1.

The success rate for patients of different age groups. There is no significant difference in the success rate for patients of different age groups (p = 0.138; ANOVA with Tukey multiple comparisons).

Figure 2.

The distribution of tube retention time and the proportion of unexpectedly dislocated tubes. The tube retention time of 103 of 233 eyes (44.2%) was between 3 to 6 months, and was between 1 to 3 months for 53 of 233 eyes (22.7%). The proportion of unexpectedly removed tubes is marked off with dark gray boxes.

Figure 3.

The success rate according to the tube retention time. Each group, even the group in which tube retention time was less than 2 weeks, shows no significant difference in success rate (p = 0.066; ANOVA with Tukey multiple comparisons).

Table 1.

Demographics

Factor	n = 233 (eye)	%
Sex
M	133	57.1
F	100	42.9
Age (mean 3.4 ± 2.1 yr)
1-2 yr	68	29.2
2-3 yr	59	25.3
3-4 yr	40	17.2
4-5 yr	23	9.9
5-6 yr	15	6.4
6-7 yr	10	4.3
7 yr-	18	7.7
Side
Right	129	55.4
Left	104	44.6
Bilaterality	33	14.2
History of dacryocystitis	10	4.3
Canalicular stenosis	7	3.0
Punctal occlusion	10	4.3
Probing history	67	28.8

Table 2.

Success rate according to planning of tube removal and symptom

n = 233	Symptom	Success rate %	p-value
Unexpected tube removal (100)	+ (13)	53.8	<0.001^∗
	- (87)	93.1
Planned tube removal (133)	+ (8)	25.0	<0.001^∗
	- (125)	88.8	<0.001

Success rate was significantly lower in patients with persistent epiphora regardless of whether the tube removal was done according to plan.

^∗ Pearson's chi-square tests.

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