Tags

Type your tag names separated by a space and hit enter

Monocanalicular silastic intubation for the initial correction of congenital nasolacrimal duct obstruction.
J AAPOS. 2007 Apr; 11(2):183-6.JA

Abstract

BACKGROUND

Treatment of persistent nasolacrimal duct (nasolacrimal duct obstruction) obstruction traditionally has consisted of simple probing. The most common complication with this approach has been recurrent obstruction, requiring another probing, often with the use of bicanalicular silastic intubation. Monocanalicular silastic tubing offers the possibility of increased success rates over simple probing while theoretically minimizing the insertion and removal difficulaties posed by bicanalicular techniques. We report, to our knowledge, the largest series to date of patients undergoing monocanalicular silastic intubation, as well as the first report evaluating this technique as the primary treatment for congenital nasolacrimal duct obstruction obstruction.

METHODS

This was a retrospective chart review of 635 children treated by 3 pediatric ophthalmologists via probing with monocanalicular silastic intubation as the initial procedure for congenital nasolacrimal duct obstruction obstruction. Success was defined as good clearance of fluorescein dye and/or the absence of symptomatic tearing. Failure was defined as recurrent symptomatic tearing or inadequate clearance of fluorescein dye, leading to the performance of a second tear duct operation.

RESULTS

We identified 635 children who underwent probing with monocanalicular intubation as the primary treatment for congenital nasolacrimal duct obstruction obstruction (mean age at time of probing 18 months). The overall success rate for the 803 eyes undergoing surgery was 96%. The success rate for treatment performed in infants younger than 24 months of age (684 eyes) was 97%, declining to 90% when surgery was performed in infants older than 24 months of age (119 eyes; p < 0.001). These success rates compare favorably to previous reports of primary probing without silastic intubation, especially in children older than 12 months at the time of the probing. The only complication in the current study was conjunctival-corneal abrasion, occurring in 2% of cases.

CONCLUSIONS

Probing with monocanalicular silastic intubation as the initial surgical procedure for patients with congenital nasolacrimal duct obstruction obstruction is associated with a very high success rate and low complication rate, especially when performed by the age of 24 months.

Authors+Show Affiliations

UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. engel@uceyecenter.com <engel@uceyecenter.com>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17307001

Citation

Engel, J Mark, et al. "Monocanalicular Silastic Intubation for the Initial Correction of Congenital Nasolacrimal Duct Obstruction." Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus, vol. 11, no. 2, 2007, pp. 183-6.
Engel JM, Hichie-Schmidt C, Khammar A, et al. Monocanalicular silastic intubation for the initial correction of congenital nasolacrimal duct obstruction. J AAPOS. 2007;11(2):183-6.
Engel, J. M., Hichie-Schmidt, C., Khammar, A., Ostfeld, B. M., Vyas, A., & Ticho, B. H. (2007). Monocanalicular silastic intubation for the initial correction of congenital nasolacrimal duct obstruction. Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus, 11(2), 183-6.
Engel JM, et al. Monocanalicular Silastic Intubation for the Initial Correction of Congenital Nasolacrimal Duct Obstruction. J AAPOS. 2007;11(2):183-6. PubMed PMID: 17307001.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Monocanalicular silastic intubation for the initial correction of congenital nasolacrimal duct obstruction. AU - Engel,J Mark, AU - Hichie-Schmidt,Claire, AU - Khammar,Alexander, AU - Ostfeld,Barbara M, AU - Vyas,Amy, AU - Ticho,Benjamin H, Y1 - 2007/02/15/ PY - 2006/04/09/received PY - 2006/09/11/revised PY - 2006/09/12/accepted PY - 2007/2/20/pubmed PY - 2007/5/30/medline PY - 2007/2/20/entrez SP - 183 EP - 6 JF - Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus JO - J AAPOS VL - 11 IS - 2 N2 - BACKGROUND: Treatment of persistent nasolacrimal duct (nasolacrimal duct obstruction) obstruction traditionally has consisted of simple probing. The most common complication with this approach has been recurrent obstruction, requiring another probing, often with the use of bicanalicular silastic intubation. Monocanalicular silastic tubing offers the possibility of increased success rates over simple probing while theoretically minimizing the insertion and removal difficulaties posed by bicanalicular techniques. We report, to our knowledge, the largest series to date of patients undergoing monocanalicular silastic intubation, as well as the first report evaluating this technique as the primary treatment for congenital nasolacrimal duct obstruction obstruction. METHODS: This was a retrospective chart review of 635 children treated by 3 pediatric ophthalmologists via probing with monocanalicular silastic intubation as the initial procedure for congenital nasolacrimal duct obstruction obstruction. Success was defined as good clearance of fluorescein dye and/or the absence of symptomatic tearing. Failure was defined as recurrent symptomatic tearing or inadequate clearance of fluorescein dye, leading to the performance of a second tear duct operation. RESULTS: We identified 635 children who underwent probing with monocanalicular intubation as the primary treatment for congenital nasolacrimal duct obstruction obstruction (mean age at time of probing 18 months). The overall success rate for the 803 eyes undergoing surgery was 96%. The success rate for treatment performed in infants younger than 24 months of age (684 eyes) was 97%, declining to 90% when surgery was performed in infants older than 24 months of age (119 eyes; p < 0.001). These success rates compare favorably to previous reports of primary probing without silastic intubation, especially in children older than 12 months at the time of the probing. The only complication in the current study was conjunctival-corneal abrasion, occurring in 2% of cases. CONCLUSIONS: Probing with monocanalicular silastic intubation as the initial surgical procedure for patients with congenital nasolacrimal duct obstruction obstruction is associated with a very high success rate and low complication rate, especially when performed by the age of 24 months. SN - 1091-8531 UR - https://www.unboundmedicine.com/medline/citation/17307001/Monocanalicular_silastic_intubation_for_the_initial_correction_of_congenital_nasolacrimal_duct_obstruction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1091-8531(06)00531-3 DB - PRIME DP - Unbound Medicine ER -