silicon and Lacrimal-Duct-Obstruction

To determine the success rates and compare the results of balloon catheter dilation and nasolacrimal intubation as treatment for congenital nasolacrimal duct obstruction after failed probing, stratified by category of age and type of obstruction.. It was a prospective, randomized, clinical trial that enrolled 189 children (245 eyes) aged between 6 months to 48 months who had a history of failed nasolacrimal duct probing. All eyes underwent either balloon catheter nasolacrimal duct dilation or nasolacrimal duct intubation randomly. The eyes were divided into 2 age categories: category 1 (6-24 months) and category 2 (>24 months) and into 2 types of obstructions: simple obstruction and complex obstruction. Treatment success was defined as absence of epiphora, mucous discharge, or increased lacrimal lake at the outcome visit 6 months after surgery. Complications were also compared.. In 124 eyes treated with balloon catheter dilatation, 112 were successful (90.3%) comparing with 106 successful eyes (87.6%) in 121 eyes treated with nasolacrimal duct intubation. The risk ratio for success between intubation and balloon dilation was 0.971, and the 95% confidence interval was 0.95-1.22. Within each age category, the success rate varied but did not show significant difference: In those under 24 months, success rate was 89.7% in 97 eyes treated with intubation, and 91.9% in 99 eyes treated with balloon dilation (RR, 0.976; 95% CI, 0.590-0.956). In those above 24 months, success rate was 79.1% in 24 eyes treated with intubation, and 84.0% in 25 eyes treated with balloon dilation (RR, 0.942; 95%CI, 0.813-1.387). In the group of simple obstruction, success rate was 96.5% in 87 eyes treated with intubation, and 93.1% in 88 eyes treated with balloon dilation (RR, 1.036; 95% CI, 0.967-1.105). In the group of complex obstruction, Success rate was 64.7% in 34 eyes treated with intubation, and 86.1% in 36 eyes treated with balloon dilation. The success rate of balloon dilatation showed slightly higher than that of intubation (RR, 0.751; 95% CI, 0.590-0.956). There were 59 eyes showed complications in intubation group, while only 2 eyes in balloon dilation group.. Both balloon catheter dilation and nasolacrimal duct intubation could alleviate the clinical signs of persistent nasolacrimal duct obstruction with a similar percentage of patients. In the complex obstruction group, balloon catheter dilation showed better efficacy than nasolacrimal duct intubation.

Topics: Child, Preschool; Dilatation; Humans; Infant; Intubation; Lacrimal Duct Obstruction; Nasolacrimal Duct; Prospective Studies; Silicon; Treatment Outcome

The treatment options for canalicular obstruction remain controversial, and there are different approaches. In this study, we aimed to evaluate the success of balloon dilatation and silicon tube intubation according to the etiology in patients with canalicular obstruction.. The files of 91 patients with isolated monocanalicular obstruction were retrospectively reviewed. Patients were grouped according to surgical methods (Group A: both balloon dilatation and silicon tube intubation; Group B: Only balloon dilatation) and etiologies (topical anti-glaucomatous usage-related, inflammatory, chemotherapy-related, radiotherapy-related, trauma-related, idiopathic). Preoperative and postoperative Munk scores and lacrimal irrigation results were noted in all cases.. Munk score was found to be statistically significantly lower in the 1st year in both groups. The patency rate with lacrimal syringing was found to be statistically significantly higher in group A. Success rates both in the munk score and lacrimal passage patency were found to be statistically significantly lower in inflammatory etiology than other etiologies.. Both techniques can be used as first-line therapies for canalicular obstruction. It should be considered that recurrence may develop in stenosis of inflammatory origin and more invasive surgery may be required.

Topics: Dacryocystorhinostomy; Humans; Intubation; Lacrimal Duct Obstruction; Nasolacrimal Duct; Retrospective Studies; Silicon; Treatment Outcome

To evaluate the delivery time, type of delivery, age at the time of operation, and surgical methods applied in cases of congenital nasolacrimal duct obstruction (CNLDO).. This study retrospectively included a total of 207 eyes of 160 cases who underwent surgery for CNLDO between February 2012 and April 2021. According to their age at the time of operation, the cases were divided into 0-12, 12-24, 24-36, 36-48 and > 48 months groups. The cases were evaluated as term/preterm according to the delivery time and cesarean section/vaginal delivery according to the type of delivery. The surgical methods applied were examined as probing alone and probing plus silicone tube implantation.. Of the cases, 146 (91.2%) were born at term and 14 (8.7%) were born preterm, and there was no statistically significant difference in the silicone tube implantation rates according to the time of delivery. The rate of silicone tube implantation was statistically significantly higher in the vaginal delivery group than in the cesarean section group (p = 0.001; p < 0.01). The rate of silicone tube implantation was higher in those who were older than the age of the operation.. Although the rate of those who were born by cesarean section was higher in probing cases, those who required silicone intubation were more common in those who were born vaginally. This suggests that dacryostenosis in the vaginally born cases resulted from a persistent structural and anatomical obstruction despite the presence of a high intrauterine pressure increase and enzymatic lysis.

Topics: Cesarean Section; Child, Preschool; Dacryocystorhinostomy; Eye Abnormalities; Female; Humans; Infant; Infant, Newborn; Intubation; Lacrimal Duct Obstruction; Nasolacrimal Duct; Pregnancy; Retrospective Studies; Silicon; Silicones; Treatment Outcome

The aim of this study was to perform a retrospective review of the outcome of silicon intubation using the Ritleng probe and a modified braided silk suture (Ethicon Sutupak) fixed in a silicone tube in children with congenital nasolacrimal duct obstruction (CNLDO).. Records of all children between 1 and 12 years of age who underwent silicone tube intubation with the Ritleng probe and Ethicon Sutupak suture (2-0) fixed in silicone tube for CNLDO with a minimum of 1-year follow-up were identified. The hollow Ritleng probe was inserted via the canaliculus into the inferior meatus. The Sutupak thread-guide, attached to the silicone tube, was advanced through the probe lumen and retrieved using a hook under endoscopic visualization. The tube ends were tied to each other and tube removal was planned after 3 months. Absence of watering, discharge, and matted lashes after removal of silicone tube was defined as success.. One hundred and fifty-two eyes of 152 children with a mean age of 3.26 ± 2.3 years were included in the study. The procedure was successful in 145 eyes (95%) after removal of the silicone intubation with relief of symptoms observed in most patients by fifth-day follow-up (n = 120 eyes, 83%). The mean duration of follow-up was 3.48 ± 1.3 years. No other significant differences were observed between patients who did (n = 47) and did not (n = 105) have previous probing including success rates (95% vs. 96%, P = 0.89).. Silicone intubation with Ritleng probe and Sutupak suture fixed in silicone tube was successful in resolution of symptoms of CNLDO in majority of patients. Using a low-cost suture did not affect success rates.

Topics: Child; Child, Preschool; Dacryocystorhinostomy; Humans; Infant; Intubation; Lacrimal Duct Obstruction; Nasolacrimal Duct; Retrospective Studies; Silicon; Silicones; Sutures; Treatment Outcome

This study aims at comparing two different types of drainage tubes in conjunctivodacryocystorhinostomy, which are used for upper lacrimal system obstruction or damage, with respect to their respective postoperative problems and solutions.. Nineteen eyes of 17 patients who underwent conjunctivodacryocystorhinostomy (CDCR) or conjunctivorhinostomy (CR) surgery with a Medpor coated tear drainage tube or silicon tube placement between October, 2010, and February, 2014, were included in this retrospective comparative study.. In the initial surgery, Medpor coated tear drainage tubes were used in 11 eyes by CDCR, whereas silicon tear drainage tubes were implanted into 2 eyes by CR and 6 eyes by CDCR. In group 1, proximal and distal obstructions developed postoperatively in 4 eyes, while 1 eye showed tube malposition and 3 eyes developed luminal obstruction by debris 3 times. In group 2, tube extrusion developed in 4 eyes, whereas tube malposition developed in 6 eyes and luminal obstruction by debris developed in 6 eyes at different times, for a total of 20 times.. In our study, the most significant complication we observed in the use of silicon tear drainage tubes was tube extrusion,whereas the leading complication related to the use of Medpor coated tear drainage tubes was tube obstruction.

Topics: Adult; Aged; Biocompatible Materials; Conjunctiva; Dacryocystorhinostomy; Drainage; Female; Humans; Lacrimal Apparatus; Lacrimal Duct Obstruction; Male; Middle Aged; Polyethylenes; Postoperative Complications; Retrospective Studies; Silicon; Tears

It is hard to cure dacryocystitis caused by a paranasal sinus mucocele with treatment which only targets the mucocele. Also, it is difficult to identify the lacrimal sac and the nasolacrimal duct preoperatively and intraoperatively when the lacrimal passage is markedly changed by the mucocele or previous surgery. We experienced four cases of mucocele complicated by lacrimal stenosis or obstruction. We performed marsupialization of the mucocele and direct silicon intubation or endoscopic dacryocystorhinostomy simultaneously with the use of a fiberoptic illuminator or dacryoendoscopy. Assisted by those devices, lacrimal procedures can now be done quickly and safely regardless of the surgeon's experience. In addition, performing surgeries both for the lacrimal passage and for the mucocele at the same time can minimize the burden on patients.

Topics: Aged; Dacryocystorhinostomy; Endoscopy; Female; Humans; Lacrimal Duct Obstruction; Male; Middle Aged; Mucocele; Paranasal Sinus Diseases; Silicon

To evaluate the outcome of nasolacrimal intubation as a primary treatment of congenital nasolacrimal duct obstruction (NLDO) in children up to 4 years of age.. During the 3 years period from July 2008 to June 2011, in the Paediatric Ophthalmology Department. Alshifa Trust Eye Hospital, Rawalpindi, 65 eyes of 59 children, aged 12 to 48 months with congenital NLDO and no prior Nasolacrimal duct surgery were enrolled. After written informed consent, all nasolacrimal intubations using olive tip silicon tube were performed under general anaesthesia. The planned tube retention was at least 3 months. The study outcome visit was timed 1 month after tube removal and treatment success was analyzed. Intra operative and post operative complications were also noted. Data were analyzed by SPSS 16. Frequencies and percentages were calculated for categorical variables. Mean +/- SD were computed for age and duration of intubation. Chi-square test was used to compare proportion of outcomes in different age groups and duration.. The overall success rate of Nasolacrimal intubation as a primary treatment of congenital NLDO was 89% in children between 12 to 48 months age (mean 25.8 +/- 9.8 months). The success was 92% in children under 2 years of age (P < 0.0001) and 90% in children between 2-3 years of age (P < 0.0001). The procedure remained less successful in children between 3-4 years of age (P < 0.2860) as compared to children under 3 years of age. The success rate was consistently high (92.3%) when the tube was left in situ for more than 3-6 months (P < 0.0001).. Nasolacrimal intubation with Olive tip silicon intubation tube is a successful procedure as a primary treatment of Nasolacrimal duct obstruction in children under 4 years of age.

Topics: Chi-Square Distribution; Child, Preschool; Dacryocystorhinostomy; Female; Humans; Infant; Intubation; Lacrimal Duct Obstruction; Male; Silicon; Treatment Outcome

Topics: Humans; Infant; Intubation; Lacrimal Duct Obstruction; Silicon

To evaluate the efficacy of the Ritleng lacrimal intubation system in the treatment of congenital nasolacrimal duct obstruction.. Twenty-six patients (29 eyes) with congenital nasolacrimal duct obstruction, who ranged in age from 2 to 12 years (mean, 4.85 +/- 2.9 years), underwent silicone intubation with the Ritleng lacrimal intubation system. The Ritleng lacrimal intubation system is composed of a Ritleng probe, a monofilament guide thread and a silicone tube. The prolene tip was removed from the inferior meatus with nasal endoscopy in 26 eyes, whereas this was done by using a Ritleng hook in 3. Clinical success was defined by the relief from symptoms and signs of obstruction. The tubes were left in place for an average of 6 months. The patients were followed up between 6 and 25 months (mean, 8.3 months).. All cases were successfully intubated with the Ritleng system. Two cases underwent reintubation because of tube dislocation during the first week. Granuloma developed at the edge of the inferior punctum in 1 case. We observed relief from symptoms in all cases.. The Ritleng lacrimal intubation system is an easy, effective and nontraumatizing procedure for the treatment of congenital nasolacrimal duct obstruction.

Topics: Child; Child, Preschool; Equipment Design; Female; Follow-Up Studies; Humans; Intubation; Lacrimal Duct Obstruction; Male; Nasolacrimal Duct; Polypropylenes; Recurrence; Silicon; Stents; Treatment Outcome