Hakan Demirci1, Victor M Elner. 1. Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA.
Abstract
OBJECTIVE: To evaluate the effectiveness of double silicone intubation for the management of partial lacrimal drainage system obstruction in adults. DESIGN: Observational retrospective case series. PARTICIPANTS: Twenty-four eyes of 18 consecutive adult patients with partial lacrimal system obstruction managed at the University of Michigan. METHODS: Retrospective review of symptoms and signs, duration of silicone intubation, and complications. MAIN OUTCOME MEASURE: Resolution of tearing. RESULTS: Preoperative tearing, negative Jones I testing, positive Jones II testing, and resistance to positive-pressure irrigation were present in all eyes (100%). The first silicone tube was removed after a mean of 11+/-7 months, and the second tube after 16+/-6 months. Postoperatively, at a mean of 21+/-9 months after removal of both tubes, tearing remained resolved in 19 eyes (79%) and remained improved in 2 eyes (8%). In eyes with resolved tearing, Jones I testing became positive, and there was no resistance to positive-pressure irrigation. Persistent tearing in 3 eyes (13%) required treatment with external dacryocystorhinostomy. The only complication was peripunctal pyogenic granulomas in 2 eyes. CONCLUSION: Double silicone intubation is an effective minimally invasive technique for treatment of partial lacrimal system obstruction in adults.
OBJECTIVE: To evaluate the effectiveness of double silicone intubation for the management of partial lacrimal drainage system obstruction in adults. DESIGN: Observational retrospective case series. PARTICIPANTS: Twenty-four eyes of 18 consecutive adult patients with partial lacrimal system obstruction managed at the University of Michigan. METHODS: Retrospective review of symptoms and signs, duration of silicone intubation, and complications. MAIN OUTCOME MEASURE: Resolution of tearing. RESULTS: Preoperative tearing, negative Jones I testing, positive Jones II testing, and resistance to positive-pressure irrigation were present in all eyes (100%). The first silicone tube was removed after a mean of 11+/-7 months, and the second tube after 16+/-6 months. Postoperatively, at a mean of 21+/-9 months after removal of both tubes, tearing remained resolved in 19 eyes (79%) and remained improved in 2 eyes (8%). In eyes with resolved tearing, Jones I testing became positive, and there was no resistance to positive-pressure irrigation. Persistent tearing in 3 eyes (13%) required treatment with external dacryocystorhinostomy. The only complication was peripunctal pyogenic granulomas in 2 eyes. CONCLUSION: Double silicone intubation is an effective minimally invasive technique for treatment of partial lacrimal system obstruction in adults.