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Clinical science
Prospective randomised comparison of external dacryocystorhinostomy with and without silicone intubation
  1. R Saiju1,
  2. L J Morse2,
  3. D Weinberg3,
  4. M K Shrestha1,
  5. S Ruit1
  1. 1
    Tilganga Eye Centre, Kathmandu, Nepal
  2. 2
    University of Vermont College of Medicine, Burlington, Vermont, USA
  3. 3
    Department of Ophthalmology, University of Utah, Salt Lake City, Utah, USA
  1. Correspondence to Dr R Saiju, Oculoplastic and Lacrimal Clinic, Tilganga Eye Centre, P.O. Box #561, Kathmandu, Nepal; rsaiju{at}


Background/aims: The aim of the study was to compare surgical outcomes of external dacryocystorhinostomy (DCR) with and without silastic intubation for treatment of primary uncomplicated nasolacrimal duct obstruction (NLDO).

Design: The study was a prospective randomised trial conducted at the Tilganga Eye Centre (Kathmandu, Nepal).

Methods: One-hundred 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. Silicone tubes increased surgical cost by 20% at the Tilganga Eye Centre.

Conclusion: DCR without silastic intubation is less expensive than DCR with silastic intubation in primary uncomplicated NLDO, and has a similar success rate. 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, the use of silastic intubation in DCR may be unnecessary.

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  • Competing interests None declared.

  • Provenance and Peer review Not commissioned; not externally peer reviewed.

  • Ethics approval Ethics approval was obtained from the Tilganga Eye Centre ethical review committee.

  • Patient consent Obtained

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