J Korean Ophthalmol Soc.  2016 Aug;57(8):1199-1204. 10.3341/jkos.2016.57.8.1199.

Clinical Effects of Intranasal Steroid Application after Silicone Tube Intubation in Nasolacrimal Duct Obstruction

Affiliations
  • 1Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea. jongsool@pusan.ac.kr
  • 2Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 3Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Korea.

Abstract

PURPOSE
To investigate the effects of intranasal steroid spray after silicone tube intubation in nasolacrimal duct obstruction.
METHODS
We included 73 patients (73 eyes) who had undergone silicone tube intubation with partial nasolacrimal duct obstruction and who had been followed-up for more than 6 months. We divided them into two groups: Group 1 (37 patients, 37 eyes), who used intranasal steroid spray twice a day for 4 weeks after silicone tube intubation, and Group 2 (36 patients, 36 eyes), who did not use intranasal steroid spray. A retrospective medical record review was performed to analyze the clinical features of epiphora improvement and complications in the two groups.
RESULTS
No significant difference was found in epiphora improvement after surgery between the two groups (33 eyes [89.2%] in Group 1, 31 eyes [86.1%] in Group 2) (p = 0.736). In addition, the difference in success rate between the two groups was also not statistically significant (33 eyes [89.2%] in Group 1, 28 eyes [77.8%] in Group 2) (p = 0.221). Group 1 (5/37 [13.5%] eyes) and Group 2 (12/36 [33.3%] eyes) complained of ocular discomfort during the period of silicone tube intubation (p = 0.045). The complication rate of Group 1 (5/37 [13.5%] eyes) was significantly lower than that of Group 2 (13/36 [36.1%] eyes) (p = 0.024).
CONCLUSIONS
Silicone tube intubation is an effective treatment option for adults diagnosed with partial nasolacrimal duct obstruction, and postoperative intranasal steroid application may contribute to improvement of ocular symptoms after the surgery. There may be a merit of using intranasal steroid spray for adjuvant therapy to prevent postoperative complications, but it needs further study considering various factors.

Keyword

Intranasal steroid spray; Nasolacrimal duct obstruction; Silicone tube intubation

MeSH Terms

Adult
Humans
Intubation*
Lacrimal Apparatus Diseases
Medical Records
Nasolacrimal Duct*
Postoperative Complications
Retrospective Studies
Silicon*
Silicones*
Silicon
Silicones

Figure

  • Figure 1. The rate of epiphora improvement and clinical success outcome in patients used cicleosonide after silicone tube intubation. (A) Epiphora improvement rate, (B) Clinical success outcome rate. But there was no significant difference between group 1 and group 2 (p = 0.736 [A], p = 0.221 [B], Fisher's exact test).


Reference

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