Retrograde intubation procedure in the treatment of nasolacrimal duct obstruction

Abstract

Objective To investigate the influence of bony lacrimal passage anatomy in the management of nasolacrimal duct obstruction treated by retrograde intubation procedure.Methods 75 eyes of 71 cases of primary nasolacrimal duct obstruction in adults were studied.The patients underwent three-dimensional CT imaging before surgery to detect the length and minimum diameter of bony lacrimal passage.The Y shape silicone tubes were intubated in lacrimal passages retrogradely.The tubes were removed at 3 months after surgery.The patients were followed up for over 1 year.Results The tubes were intubated successfully by one surgery in all cases.When the tubes were removed,saline irrigation revealed complete free passages in 67 eyes (89.33％) and some blockage in 8 eyes (10.67％).At 1-3 months after removal of the tubes,canalicular obstructions were found in 14 eyes.These 14 cases were regarded as the uncured group and other 61 eyes were regarded as the cured group.The average lengths of bony lacrimal passage were (13.40 ± 0.51) mm in the cured group and (13.71 ± 0.41) mm in the uncured group.The minimum diameters of bony lacrimal passage were (3.47 ±0.34) mm in the cured group and (3.23 ±0.28) mm in the uncured group.The differences of average lengths and minimal diameters of bony lacrimal passage in two groups were statistically significant (t =4.81,P ＜ 0.01 ; t =5.64,P ＜ 0.01).Conclusion Retrogarde intubation procedure has good clinical efficacy in the treatment of nasolacrimal duct obstruction.The individual operation should be designed based on the three-dimensional CT imaging of bony lacrimal passage to increase the success rate of surgery. Key words: Obstruction, nasolacrimal duct; Intubation, retrograde; Study, clinical