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

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.

Comparison Results of Silicone Tube Intubation According to Syringing and Dacryocystography

PURPOSE: To compare the surgical success rate of silicone tube intubation according to the preoperative lacrimal syringing test and dacryocystography (DCG) in adult patients with epiphora. METHODS: Medical records of 142 patients who underwent silicone tube intubation were retrospectively reviewed. The surgical results were divided into 3 groups based on postoperative symptoms and the syringing test results: Good, Fair, and Fail. Good and Fair were classified into the surgical success groups. We compared the surgical success rate according to the preoperative syringing test and stenosis site observed on dacryocystography. RESULTS: The success rates of silicone tube intubation were 88.4% and 87.4% in eyes with preoperative syringing results of totally-passed and partially-passed syringing tests, respectively, revealing no statistically significant differences (p = 0.838, chi-square test). However, in eyes with the preoperative syringing results of partially-passed syringing tests, the success rates were 66.7% in patients with canalicular stenosis, 83.3% in patients with nasolacrimal duct stenosis, and 94.5% in those with diffuse stenosis (p = 0.018, chi-square test). CONCLUSIONS: No significant differences were found in the success rates of silicone tube intubation according to preoperative syringing test results. However, when considered together with DCG findings, the lowest success rate was found in eyes with the partially-passed syringing test and simultaneously showed canalicular stenosis on DCG. The syringing test results considered with DCG findings may help predict the success rates of silicone tube intubation.