Clinical Effectiveness of Monocanalicular and Bicanalicular Silicone Intubation for Congenital Nasolacrimal Duct Obstruction

Abstract

Numerous surgical techniques of silicone tube intubation in congenital nasolacrimal duct obstruction (CNLDO) have been described; these techniques can be divided into monocanalicular intubation (MCI) and bicanalicular intubation (BCI). The aim of this study was to compare the clinical effectiveness of MCI versus BCI of CNLDO. In a prospective, nonrandomized, comparative case study, patients with CNLDO underwent probing under endoscopic control and either BCI or MCI under general anesthesia. Demographic data, including age and sex, duration of preoperative symptoms, method of previous treatment, operative time, timing of silicone tube removal, follow-up periods, complications, and outcomes, were analyzed. The study included 30 eyes from 22 patients for BCI and 30 eyes from 24 patients for MCI. The mean age in the BCI group was 23.3 months and in the MCI group was 23.1 months. Mean follow-up was 16.4 ± 5.9 weeks for BCI group and 11.6 ± 8.2 weeks for MCI group. Operation time was slightly longer in the BCI group. Tubes were most often removed in the operating room under general anesthesia for BCI (66.7%) and in an office setting under topical anesthesia for MCI (100%). Overall, BCI had a 93.3% success rate (28/30), and MCI had a 90.0% success rate (27/30). Although there was no significant difference between the success rates of the 2 groups, MCI allowed technical ease of insertion and tube removal. Moreover, the tubing does not threaten the unprobed part of the lacrimal drainage system. These advantages of MCI should be considered when selecting treatment methods for CNLDO.