Combination Surgery of Silicone Tube Intubation and Conjunctival Resection in Patients with Epiphora

Abstract

PurposeTo compare the success rates of performing only silicone tube intubation versus carrying out both conjunctival resection and silicone tube intubation.MethodsThe subjects of this study involved 62 patients (96 eyes) between October 2015 and May 2017 who were diagnosed as having punctal stricture or nasolacrimal duct stenosis. Out of 96 eyes, 47 underwent only silicone tube intubation, and 49 underwent both silicone tube intubation and conjunctival resection. Three parameters were measured at 1, 3, and 6 months after the surgery: the area of the tear meniscus using RTVue-100 anterior segment optical coherence tomography, the height of the tear meniscus using a slit lamp microscope, and the subjective satisfaction of patients as a result of improved sympotms like epiphora. The surgery was considered successful when the patients' experienced the resolution of symptoms and reduction of the area and height of the tear meniscus.ResultsThe area of the tear meniscus, height of the tear meniscus, and subjective satisfaction of patients was superior in the group that underwent both silicone tube intubation and conjunctival resection compared silicone tube intubation only. Based on these results, the success rate of the surgery was 68.9% in the group that underwent only silicone tube intubation and 78.7% in the group that underwent both silicone tube intubation and conjunctival resection.ConclusionsThe resection of relaxed plica semilunares seems to increase the success rate of silicone tube intubation through the reduction of the area and height of the tear meniscus. Therefore, after determining the degree of conjunctivochalasis, if it was found to be severe, a combination with conjunctival resection was expected to increase the success rate of the surgery.

Outcomes of intubation techniques in nasolacrimal duct blockage in adult age group: a comparative study based on Sindh, Pakistan population

“…One of the study results reveled that application of silicon tube intubation showed higher rate of success in advance age group with mean age of 59.8±7.18 similar in present study. 1 Success rate was observed in given study in both group comprises of silicon tube intubation and dacryocystography with pre-operative syringing test were applied in advance age group, the mean age in sub groups were 62.3±10.9 and 58.6±10.3, that showed similar to our study results success rate of both procedure in adults and old age with minimal rate of complication and prolong follow up. 12 Similar to the present study the evidence of that study describe the success rate of silicon tube intubation in advance age group with free of symptoms and complications.…”

“…Epiphora associated with multiple underlying causes such as trauma, radiotheraphy, burn or drugs had wide contribution. 1 The silicon tube was mainly presented by keth. Who applied the procedure in patient with nasolacrimal duct obstruction as an alternative of commonly used skills.…”

Surgical outcomes of endoscopic dacryocystorhinostomy: analysis of age effect

“…Kim et al . 23 compared the surgical outcomes of silicone tube intubation alone versus in combination with conjunctival resection in patients with NLD stenosis accompanied by conjunctivochalasis, and reported that the success rate, tear meniscus height, and patient’s satisfaction were all superior in the combined surgery group. To improve surgical outcomes after EDCR in older patients, simultaneous eyelid tightening procedure and/or conjunctival resection with EDCR may be helpful for the treatment of epiphora resulting from eyelid laxity, conjunctivochalasis and NLDO.…”

Comparable anatomical and functional success to younger patients in endoscopic dacryocystorhinostomy patients of older age

“…Kim et al [23] compared the success rates of only silicone tube intubation with the combination of conjunctival resection and silicone tube intubation in patients with nasolacrimal duct obstruction. It was concluded that performing resection for the relaxed plica semilunares increases the success of silicone tube intubation.…”