The outcome of silicone intubation and tube removal in external dacryocystorhinostomy patients with distal canalicular obstruction

PURPOSE. To evaluate the outcome of silicone intubation and tube removal in external dactyocystorhinostomy (DCR) patients with distal canalicular or common canalicular obstruction. METHODS. Seventy-five eyes of 69 patients with distal or common canalicular obstruction who had undergone external DCR and silicone tube insertion were included in the study. Silicone tube was left in place at least for 3 months. Presence of epiphora was questioned and patency was assessed by irrigation at each control after tube removal. RESULTS. Mean patient age was 49.8 +/- 14.4 years (range 15-78) and mean follow-up after surgery was 13.2 +/- 4.2 months (range 6-25). After tube removal, 16 eyes (21.3%) presented with epiphora and occluded canalicular systems. Two eyes (2.7%) presented with epiphora which started just after tube removal and had a patent canalicular system. Fifty-seven eyes (76%) were free of symptoms and had patent canalicular systems and 3 of these eyes (4%) had epiphora while the tube was in place. CONCLUSIONS. Silicone intubation is indicated in patients with distal or common canalicular obstruction. The majority of patients with canalicular problems are relieved of epiphora after silicone tube removal. However, the tube itself may transiently occlude the canalicular system and cause epiphora in some patients, and in some it can aid tear flow even in the presence of a patent system.