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Correlation Between Irrigation Around the Silicone Tube After Endoscopic Dacryocystorhinostomy with Clinical Symptoms and Surgical Outcome

Cesar Sierra, J.Javier Servat, Samuel Yun, Geoffrey Gladstone, Frank Nesi.

Abstract
Purpose: To assess the value of irrigation around the silicone tubes after endoscopic dacryocystorhinostomy (endo-DCR) for nasolacrimal obstruction and its correlation with symptoms and surgical outcome.
Methods: Retrospective chart review of 36 consecutive endoscopic dacryocystorhinostomies. Demographic information was recorded, including: age, gender, affected eye, and success of surgery. All patients had documented primary acquired nasolacrimal duct obstruction (PANDO) before surgery.
Main Outcome Measures: Relation between irrigation of lower canaliculus around silicone tube at one week and three months post-endo-DCR and both clinical symptoms and surgical outcome.
Results: Strong correlation between the results of irrigation around the silicone tubes 3 months after endo-DCR and surgical outcome (p=0.0004). Statistical significance was also found between irrigation around the silicone tubes 3 months after endo-DCR and symptoms at the same visit (p=0.009). Little to no evidence of a correlation between irrigation at 1 week and surgical outcome (p=0.567) and between irrigation at 1 week and symptoms during the same visit (p=0.5442).
Conclusions: Irrigation around the silicone tubes 3 months after endo-DCR seems to be a reliable indicator of surgical outcome, and correlates well with symptoms. The same correlation cannot be made when the irrigation is done at 1 week.

Key words: Endoscopic dacryocystorhinostomy, Crawford tube, silicone tube, probe and irrigation, primary acquired nasolacrimal duct obstruction



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