Korean J Ophthalmol.  2016 Jun;30(3):157-162. 10.3341/kjo.2016.30.3.157.

Predictors of Silicone Tube Intubation Success in Patients with Lacrimal Drainage System Stenosis

• Baek JS
• Lee S
• Lee JH
• Choi HS
• Jang JW
• Kim SJ

• KMID: 2373970
• DOI: http://doi.org/10.3341/kjo.2016.30.3.157

Abstract

PURPOSE
To evaluate prognostic factors affecting silicone tube intubation outcomes in Asian patients with lacrimal drainage system stenosis.
METHODS
A retrospective review was conducted on the medical records of 822 patients (1,118 eyes) who had undergone silicone tube intubation to treat lacrimal drainage system stenosis between January 2011 and December 2012. Patients were divided into two groups: a success group and a failure group. Success was defined as the disappearance of epiphora symptoms, normalization of tear meniscus height, and the easy passage of fluid without resistance on the postoperative syringing test. Patient and ocular parameters were compared between the success and failure groups.
RESULTS
A total of 994 eyes of 727 patients were included in analyses. Patients had a mean follow-up period of 34.11 ± 18.70 weeks. Silicone tube intubation was successful in 67.2% of participants. Significant differences between the success and failure groups were found for age (p < 0.001), history of ipsilateral facial palsy (p = 0.028), follow-up period (p < 0.001), and degree of passage on the preoperative syringing test (p = 0.001). Only age (p < 0.001) and degree of passage on the preoperative syringing test (p = 0.002) remained significantly associated with silicone tube intubation success in multivariate analysis.
CONCLUSIONS
Age was negatively associated with silicone tube intubation success in patients with lacrimal drainage system stenosis. The success rate was higher in patients who showed easy passage of fluid without resistance on the preoperative syringing test. These factors should be considered by surgeons planning silicone tube intubation in patients with lacrimal drainage system stenosis.

Keyword

Age; Facial palsy; Lacrimal drainage system stenosis; Silicone tube intubation; Syringing test

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Dacryocystorhinostomy/*methods
Female
Follow-Up Studies
Humans
Intubation/*instrumentation
Lacrimal Duct Obstruction/*diagnosis
Male
Middle Aged
Nasolacrimal Duct/*surgery
Postoperative Period
Retrospective Studies
*Silicones
Treatment Outcome
Young Adult
Silicones

Reference

1. Keith CG. Intubation of the lacrimal passages. Am J Ophthalmol. 1968; 65:70–74.

2. Beigi B, O'Keefe M. Results of Crawford tube intubation in children. Acta Ophthalmol (Copenh). 1993; 71:405–407.

3. Fulcher T, O'Connor M, Moriarty P. Nasolacrimal intubation in adults. Br J Ophthalmol. 1998; 82:1039–1041.

4. Connell PP, Fulcher TP, Chacko E, et al. Long term follow up of nasolacrimal intubation in adults. Br J Ophthalmol. 2006; 90:435–436.

5. Shah A, Tekriwal AK, Drummond PM, Woodruff G. Long-term results of closed nasolacrimal intubation in adults. Eur J Ophthalmol. 2007; 17:490–493.

6. Lee SH, Kim SD, Kim JD. Silicone intubation for nasolacrimal duct obstruction in adult. J Korean Ophthalmol Soc. 1997; 38:185–189.

7. Lee HS, Hwang WS, Byun YJ. Clinical results of silicone intubation for nasolacrimal duct obstruction in adult. J Korean Ophthalmol Soc. 1997; 38:1926–1930.

8. Kwon YH, Lee YJ. Long-term results of silicone tube intubation in incomplete nasolacrimal duct obstruction (NLDO). J Korean Ophthalmol Soc. 2008; 49:190–194.

9. Angrist RC, Dortzbach RK. Silicone intubation for partial and total nasolacrimal duct obstruction in adults. Ophthal Plast Reconstr Surg. 1985; 1:51–54.

10. Conway ST. Evaluation and management of "functional" nasolacrimal blockage: results of a survey of the American Society of Ophthalmic Plastic and Reconstructive surgery. Ophthal Plast Reconstr Surg. 1994; 10:185–187.

11. Sohn HY, Hur J, Chung EH, Won IG. Clinical observation on silicone intubation in obstruction of lacrimal drainage system. J Korean Ophthalmol Soc. 1990; 31:135–140.

12. Kim HD, Jeong SK. Silicone tube intubation in acquired nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 2000; 41:327–331.

13. Oum JS, Park JW, Choi YK, et al. Result of partial nasolacrimal duct obstruction after silicone tube intubation. J Korean Ophthalmol Soc. 2004; 45:1777–1782.

14. Park JS, Ha SW, Lew HL. Factors affecting the long-term outcome of silicone tube intubation in patients with nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 2011; 52:129–135.

15. Sun WS, Baker RS, Chuke JC, et al. Age-related changes in human blinks: passive and active changes in eyelid kinematics. Invest Ophthalmol Vis Sci. 1997; 38:92–99.

16. Pottier F, El-Shazly NZ, El-Shazly AE. Aging of orbicularis oculi: anatomophysiologic consideration in upper blepharoplasty. Arch Facial Plast Surg. 2008; 10:346–349.

17. Lee H, Park M, Lee J, et al. Histopathologic findings of the orbicularis oculi in upper eyelid aging: total or minimal excision of orbicularis oculi in upper blepharoplasty. Arch Facial Plast Surg. 2012; 14:253–257.

18. Detorakis ET, Zissimopoulos A, Katernellis G, et al. Lower eyelid laxity in functional acquired epiphora: evaluation with quantitative scintigraphy. Ophthal Plast Reconstr Surg. 2006; 22:25–29.

19. Gumus K, Crockett CH, Pflugfelder SC. Anterior segment optical coherence tomography: a diagnostic instrument for conjunctivochalasis. Am J Ophthalmol. 2010; 150:798–806.

20. Huang Y, Sheha H, Tseng SC. Conjunctivochalasis interferes with tear flow from fornix to tear meniscus. Ophthalmology. 2013; 120:1681–1687.

21. Jeong HW, Cho NC, Ahn M. Result of silicone tube intubation in patients with epiphora who showing normal finding in dacryocystography. J Korean Ophthalmol Soc. 2008; 49:706–712.

22. Jin SW, Ahn HB, Kim MH. Long-term results of silicone tube intubation in patients with common canalicular stenosis. J Korean Ophthalmol Soc. 2012; 53:1373–1377.