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Prospective Randomized Comparison of External Dacryocystorhinostomy With and Without Silicone Intubation
  1. Rohit Saiju (rsaiju{at}tilganga.com.np),
  2. Lee Jae Morse,
  3. David Weinberg,
  4. Mohan Krishna Shrestha (research{at}tilganga.com.np),
  5. Sanduk Ruit (sruit{at}tilganga.com.np)
  1. Tilganga Eye Centre, Kathmandu, Nepal
  2. University of Vermont College of Medicine, Burlington, Vermont, United States
  3. Department of Ophthalmology, University of Utah, Salt Lake City, Utah, United States
  4. Tilganga Eye Centre, Kathmandu, Nepal
  5. Tilganga Eye Centre, Kathmandu, Nepal

    Abstract

    Purpose: To compare surgical outcomes of external dacryocystorhinostomy (DCR) with and without silastic intubation for treatment of primary uncomplicated nasolacrimal duct obstruction (NLDO).

    Design: Prospective randomized trial.

    Participants and methods: 100 consecutive patients with uncomplicated primary NLDO were randomly assigned into two groups (44 underwent DCR with silastic intubation and 56 underwent DCR without intubation). Patients were re-assessed at 1 week, 6 weeks, and 6 months after surgery. Success was defined objectively by irrigation of the puncta without regurgitation and subjectively by the absence of epiphora or discharge.

    Results: The success rate at 6 months was 90% for DCR with silastic intubation and 87% for DCR without silastic intubation. There was no statistically significant difference between the two groups (p= 0.77). No complications were encountered in either group. At Tilganga Eye Centre, silicone tubes increased surgical cost by 20%.

    Conclusion: DCR without silastic intubation is less expensive than and has a similar success rate to DCR with silastic intubation in primary uncomplicated NLDO. DCR with silastic intubation may create increased burden for patients in the form of more post-surgical follow-up visits. In cases of uncomplicated primary NLDO, use of silastic intubation in DCR may be unnecessary.

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