Gad Dotan1, Oded Ohana2, Igal Leibovitch2, Chaim Stolovitch2. 1. Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Maccabi Healthcare Services, Ramat Hasharon, Israel. Electronic address: gaddotan@hotmail.com. 2. Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
PURPOSE: To study predictors and implications on outcome of premature silicone tube-loss, a post-operative complication of monocanalicular intubation (MCI) performed for treatment of congenital nasolacrimal duct obstruction (CNLDO). METHODS: We conducted a retrospective analysis of cases of post-operative loss of monocanalicular silicone tubes occurring at one medical center from January 2007 to December 2013. RESULTS: During the study period monocanclicular silicone tubes were lost in 24/54 eyes (44%) of 19/46 children. Multivariate regression analysis identified bilateral intubation as an important predictor of early tube-loss (r=0.54, P=0.006). Seven of eight (88%) children who had both eyes intubated prematurely lost their tubes compared to 12/38 (32%) children who had unilateral intubation (P=0.005). Treatment success was lower in eyes with early tube-loss (17/24 eyes, 71%) compared to eyes with full tube retention (25/30 eyes, 83%), however this difference was not statistically significant (P=0.333). In our study, treatment outcome correlated with duration of intubation (r=0.51, P=0.002). Surgical success was achieved in 33/39 eyes (85%) in which the tubes were retained at least 2 months compared to 7/15 eyes (47%) with shorter period of intubation (P=0.012). CONCLUSIONS: Spontaneous tube-loss is a post-operative complication of monocanalicular silicone intubation that can occur more frequently than previously reported in certain populations. Tube-loss occurring soon after surgery is often associated with persistent symptoms and increased need of reoperation.
PURPOSE: To study predictors and implications on outcome of premature siliconetube-loss, a post-operative complication of monocanalicular intubation (MCI) performed for treatment of congenital nasolacrimal duct obstruction (CNLDO). METHODS: We conducted a retrospective analysis of cases of post-operative loss of monocanalicular silicone tubes occurring at one medical center from January 2007 to December 2013. RESULTS: During the study period monocanclicular silicone tubes were lost in 24/54 eyes (44%) of 19/46 children. Multivariate regression analysis identified bilateral intubation as an important predictor of early tube-loss (r=0.54, P=0.006). Seven of eight (88%) children who had both eyes intubated prematurely lost their tubes compared to 12/38 (32%) children who had unilateral intubation (P=0.005). Treatment success was lower in eyes with early tube-loss (17/24 eyes, 71%) compared to eyes with full tube retention (25/30 eyes, 83%), however this difference was not statistically significant (P=0.333). In our study, treatment outcome correlated with duration of intubation (r=0.51, P=0.002). Surgical success was achieved in 33/39 eyes (85%) in which the tubes were retained at least 2 months compared to 7/15 eyes (47%) with shorter period of intubation (P=0.012). CONCLUSIONS: Spontaneous tube-loss is a post-operative complication of monocanalicular silicone intubation that can occur more frequently than previously reported in certain populations. Tube-loss occurring soon after surgery is often associated with persistent symptoms and increased need of reoperation.