Silicone intubation with the Ritleng method using intranasal endoscopy to treat congenital nasolacrimal duct obstruction

Abstract

This study evaluated the technical properties and clinical efficacy of bicanalicular silicone intubation using the Ritleng method in children with congenital nasolacrimal duct obstruction. Thirty patients (34 eyes; mean age, 5+/-2.04 years; age range, 2-10 years) with congenital nasolacrimal duct obstruction underwent silicone intubation with the Ritleng lacrimal intubation system under endoscopic transnasal control. Removal of the silicone tube was planned 6 months after surgery. All patients were successfully intubated with the Ritleng system. One patient was lost to follow-up. We successfully evaluated the clinical results in 33 eyes of 29 patients. Stent removal in 29 of 33 eyes took place 6 months after surgery; in the other 4 eyes, the silicone tube was removed 7 to 10 months after surgery because the patients were late for their visits. One eye in which the tube had remained in place for 10 months developed a slit punctum. The mean follow-up after tube removal was 40.32+/-24.46 months (range, 12-96 months). The success rate measured as improvement of signs and symptoms of obstruction was 100%. Bicanalicular silicone intubations with the Ritleng intubation system using an intranasal endoscope for congenital nasolacrimal duct obstruction is an easy, nontraumatizing procedure that yields a high rate of success.