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.