Repositioning a Prolapsed Tube After Bicanalicular Intubation of the Lacrimal System.

Abstract

Prolapse of silicone tubes is one of the most common complications after bicanalicular intubation of the lacrimal system. This study describes a new method of repositioning prolapsed silicone tubes by using a suture-probe. This study was a retrospective chart review of 12 patients who experienced complete silicone tube prolapse after bicanalicular intubation. The silicone tube was repositioned by using a suture-probe; a double-stranded suture was placed in the lacrimal duct with a lacrimal probe with a hole in the front blunt tip, then interlocked with the prolapsed silicone tube. Subsequently, the suture loop was slowly stretched from the nasal cavity, and the silicone tube was repositioned. The silicone tube at the medial canthus was cut and loosened, then pulled out of the nasal cavity. In all 12 cases, the silicone tube was restored with 100% success by using the suture-probe. Three patients were extubated immediately after the repositioning. For another 9 patients with an indwelling tube, extubation was performed after 3-4 months, and no patients experienced further tube dislocation during that time. The suture-probe technique is a simple, low cost, and minimally traumatic method for repositioning a prolapsed silicone tube after bicanalicular intubation of the lacrimal system.A new technique, the suture-probe with thread interlocking the silicone tube ring can reposition the prolapsed silicone tube in lacrimal sac.