Pulled versus Pushed Monocanalicular Silicone Intubation in Adults with Lacrimal Drainage System Stenosis: A Comparative Case Series

Effect of Nasal Wall Fixation with Nonabsorbable Sutures during Nasolacrimal Silicone Intubation in Adults

Purpose: We explored the effects of silicone tube fixation using a nonabsorbable suture on the adult nasal wall during silicone tube intubation.Methods: The medical records of patients (50; 54 eyes) diagnosed with nasolacrimal duct stenosis and canalicular lacerations who underwent silicone tube fixation to the nasal wall (using nonabsorbable sutures) during silicone tube intubation from January 2019 to June 2021 and who were followed-up for more than 3 months after surgery were retrospectively investigated. We recorded the percentages of early silicone tube displacement and noted other complications.Results: We enrolled 22 males and 28 females of average age 65.28 ± 8.88 years. The silicone tubes were maintained for an average of 9.13 ± 1.77 weeks in the nasolacrimal duct stenosis group and 20.13 ± 3.36 weeks in the canalicular laceration group. Early tube displacement occurred in two of 46 eyes (4.4%) in the nasolacrimal duct stenosis group and in 0 of eight eyes (0%) in the canalicular laceration group. Overall, early displacement occurred in only two of 54 eyes (3.7%). Other complications included nasal irritation in four cases (7.4%), canaliculitis in three (5.6%), and loss of fixed nonabsorbable sutures in three (5.6%).Conclusions: Silicone tube fixation to the nasal wall using a nonabsorbable suture during silicone tube intubation simply and effectively prevents early tube displacement and loss, associated with minimal complications.