A new permanent lacrimal stent: evaluation of a modification to dacryocystorhinostomy

Abstract

Aim of the work The aim of this study was to evaluate the effectiveness of a new permanent lacrimal silicone stent - maintaining a patent passage from the medial wall of the lacrimal sac to the nasal cavity through a bony ostium - in the management of chronic dacryocystitis and epiphora as a simple, quick, and effective procedure. Design This was an interventional study. Patients and methods Thirty-two eyes of 28 patients attending Research Institute of Ophthalmology (RIO), complaining of epiphora due to chronic dacryocystitis or previously failed conventional dacryocystorhinostomy (DCR) surgery, are operated upon using this new modification. All patients underwent surgery in the operating theatre. The selection criterion included patients with chronic dacryocystitis, failed previous DCR, or with chronic epiphora having nasolacrimal duct obstruction with patent canalicular system. All cases were destined for classic DCR. There was no sex choice, race preference or age limitation. The only exclusion criterion was young children below the age of 3 years. Results The majority of the patients (71.4%) were women, with a male to female ratio of 2: 5. The mean age of the patients was 38 years ranging between 19 and 61 years. They were 13 right and 19 left eyes. There were four bilateral cases. The mean postoperative follow-up period to determine the success and failure was 9.5 months with a range between 7 and 14 months. In all, 15.6% of patients needed syringing once, whereas 3.1% of patients needed syringing twice after the surgery. The overall success rate of the surgery with complete resolution of epiphora was 96.9% and failure of the procedure in 3.1% of cases. It was also noticed that the failure in surgery as well as the patients who needed syringing were cases that underwent surgery as a secondary procedure as compared with cases where the procedure was done as a primary procedure. Conclusion Modified DCR with the new lacrimal silicone stent is technically quick and easy to perform and can be done for all age groups with a high success rate and could be considered as a good alternative to classic DCR surgery.