Retrospective Analysis of Bicanalicular Lacrimal Silicone Tube Intubation in Patients with Congenital Nasolacrimal Duct Obstruction: A Long-term Follow-up Study

Abstract

Congenital nasolacrimal duct obstruction (CNLDO) is the most common cause of epiphora in the first year of life. In addition to conservative therapy, there are several invasive methods available. The aim of this retrospective study was to conduct a long-term follow-up of bicanalicular lacrimal duct intubation as the primary intervention in a large cohort of patients with CNLDO. The electronic medical records of 487 patients with CNLDO who underwent bicanalicular tube intubation were reviewed. To determine the long-term outcomes, a telephone interview was conducted. A total of 328 eyes of 235 patients were included in the study. The median average follow-up period was 6.67 (5.58 – 8.67) years. At the time of the survey, 218 patients (92.8%) were symptom free. Mean patient satisfaction with surgical outcome was 10/10. To our knowledge, this study provides the longest follow-up of the largest patient cohort in the literature consisting of patients who underwent probing with bicanalicular lacrimal silicone tube intubation as a primary intervention for CNLDO. This study showed a high long-term postoperative success rate, with high postoperative satisfaction, few complications, and a low need for reintervention.

Zusammenfassung

Die angeborene Tränenwegsstenose ist die häufigste Ursache für Epiphora im ersten Lebensjahr. Neben der konservativen Therapie stehen verschiedene invasive Methoden zur Verfügung. Das Ziel dieser retrospektiven Studie war eine Langzeitbeobachtung der bikanalikulären Schlauchintubation als primäre Intervention bei einer großen Gruppe von Patienten mit angeborener Tränenwegsstenose. Es erfolgte eine Auswertung der elektronischen Krankenakten von 487 Patienten, bei denen eine bikanalikuläre Schlauchintubation durchgeführt wurde. Um die Langzeitergebnisse zu ermitteln, wurde eine telefonische Befragung durchgeführt. Insgesamt wurden 328 Augen von 235 Patienten in die Studie aufgenommen. Der Median der durchschnittlichen Nachbeobachtungszeit betrug 6,67 (5,58 – 8,67) Jahre. Zum Zeitpunkt der Umfrage waren 218 Patienten (92,8%) symptomfrei. Der Mittelwert der Zufriedenheit der Patienten mit dem Operationsergebnis lag bei 10/10. Nach unserem Kenntnisstand handelt es sich um die Studie mit der längsten Nachbeobachtungzeit der größten Patientengruppe. Diese Studie zeigte eine hohe postoperative Langzeiterfolgsrate mit hoher postoperativer Zufriedenheit, wenigen Komplikationen und wenig erneuten Eingriffen.

Conclusion Box

Already known:

• Congenital nasolacrimal duct obstruction (CNLDO) is the most common cause of epiphora in the first year of life.

• In addition to conservative therapy, there are several invasive methods available such as bicanalicular lacrimal silicone tube intubation.

• Various studies have already demonstrated a high success rate for bicanalicular lacrimal silicone tube intubation. However, the existing literature provides limited long-term data, typically up to 1 year, and studies with smaller patient cohorts.

Newly described:

• This study provides information from the largest patient cohort with the longest follow-up period in the literature for this study population.

• After a mean follow-up period of 6.67 years, our study demonstrated a success rate of 92.8%. Mean patient satisfaction with surgical outcome was 10 out of 10.

• In 8.2%, there was a recurrence of symptoms, predominantly within the initial 12-month postoperative period, with a low reoperation rate.

• Bicanalicular lacrimal silicone tube intubation therefore appears to be an effective means of treating CNLDO, with a high success rate and low complication rate, even in the long term.

Key words

congenital nasolacrimal duct obstruction - childhood epiphora - bicanalicular tube intubation - oculoplastics - tear ducts

Schlüsselwörter

kongenitale Tränenwegsstenose - Epiphora - bikanalikuläre Tränenwegsintubation

Publication History

Received: 14 September 2023

Accepted: 17 December 2023

Article published online:
26 April 2024

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