Outcome of External Dacryocystorhinostomy with Bicanalicular Silicone Tube Stenting

Objective: To evaluate the clinical outcomes of patients with nasolacrimal duct obstruction treated with external dacryocystorhinostomy and bicanalicular silicone intubation stenting. Methods: The patients were grouped as follows: Group 1, complicated cases with intubation; Group 2, complicated cases without intubation; Group 3, non-complicated cases with intubation; and Group 4, non-complicated cases without intubation. Cases without epiphora, demonstrated with free-flow lacrimal irrigation, were deemed as successful cases. Failure was defined as lack of any improvement of the symptoms. Complications related to the surgical procedure were also investigated. Results: In total, 223 external dacryocystorhinostomy procedures were performed on 201 patients. In the evaluation of complicated cases, the success rates in Groups 1 (silicone tube stenting group) and 2 (non-stenting group) were 90.9% and 77.8%, respectively (p<0.05). In the evaluation of non-complicated cases, the success rates in Groups 3 (silicone tube stenting group) and 4 (non-stenting group) were seen to be 96.2% and 98.9%, respectively (p>0.05). In 15 (13.8%) out of 108 cases who had had bicanalicular silicone tube intubation, stent displacement was observed. Lower and upper punctal synechiae developed in 1 of 6 cases with punctal complications. In 14 failed cases, successful results were obtained with external DCR and bicanalicular silicone stent intubation. Conclusion: Stenting in complicated cases increases the success rates of dacryocystorhinostomy significantly. However, we detected that in complicated cases, especially in the absence of anterior flaps, stenting does not increase success rates, contrary to posterior flap loss. No effect of stenting in non-complicated cases on surgical success rates could be demonstrated.