Published: 2019-09-25

Outcomes of intubation techniques in nasolacrimal duct blockage in adult age group: a comparative study based on Sindh, Pakistan population

Asif Mashood Qazi, Nazia Qidwai, Israr Ahmed Bhutto, Aimal Khan Penezai, Fayaz Ahmed Soomro, Hina Khan, Anus Tariq


Background: Nasolacrimal duct obstruction is listed under the heading of congenital diseases; on other hand it is also commonly present in adult age group. In population of Sindh we found these patients frequently. Through this study we revealed the surgical options for the treatment of Nasolacrimal duct obstruction in population of Sindh provenience of Pakistan. The objective of the study was to compare the outcomes of two different intubation techniques in treatment of Nasolacrimal duct obstruction between two age groups. Comparative study was conducted in the Department of Ophthalmology Al-Ibrahim Eye Hospital Karachi from May 2018 to June 2019.

Methods: Total 136 numbers of patients were included on the bases of history, clinical examination and pre-operative syringing test. Non- probability convenient sampling was applied for data collection. Total 136 numbers of patients were divided into two groups on the bases of treatment and further subgroup on the bases of age ranges. Data were analyzed by SPSS version 20.0.

Results: Frequency and percentage of recovery in six months in each subgroup with application of chi-square test. Frequency and percentage of post-operative complications prolong treatment and regurgitation and patency of tube in each group and subgroups.

Conclusions: The results showed significant difference between the groups. Group A showed higher success rate with minimal percentage of complications and post-operative measurements in both age ranges as compare to Group B.


Dacrocysto‐rhinostomy, Nasolacrimal duct obstruction, Silicon tube

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Kim ST, Jin LY, Ahn HB. Combination Surgery of Silicone Tube Intubation and Conjunctival Resection in Patients with Epiphora. Korean J Ophthalmol. 2018;32(6):438-44.

Fulcher T, O’Connor M, Moriarty P. Nasolacrimal intubation in adults. Br J Ophthalmol. 1998;82(9):1039-41.

Inatani M, Yamauchi T, Fukuchi M, Denno S, Miki M. Direct silicone intubation using Nunchaku‐style tube (NST‐DSI) to treat lacrimal passage obstruction. Acta Ophthalmologica Scandinavica. 2000;78(6):689-93.

Demirci H, Elner VM. Double silicone tube intubation for the management of partial lacrimal system obstruction. Ophthalmology. 2008;115(2):383-5.

Kashkouli MB, Pakdel F, Kiavash V. Assessment and management of proximal and incomplete symptomatic obstruction of the lacrimal drainage system. Middle East Afr J Ophthalmol. 2012;19(1):60.

Baek JS, Lee S, Lee JH, Choi HS, Jang JW, Kim SJ. Predictors of silicone tube intubation success in patients with lacrimal drainage system stenosis. Kor J Ophthalmol. 2016;30(3):157-62.

Connell PP, Fulcher TP, Chacko E, O’connor MJ, Moriarty P. Long term follow up of nasolacrimal intubation in adults. Br J Ophthalmol. 2006;90(4):435-6.

Takahashi Y, Kakizaki H, Nakano T, Asamoto K, Ichinose A, Iwaki M. Anatomy of the vertical lacrimal canaliculus and lacrimal punctum: a macroscopic study. Ophthalmic Plast Reconstr Sur. 2011;27(5):384-6.

Choi SC, Choi HS, Jang JW, Kim SJ, Lee JH. Comparison of the efficacies of 0.94 mm and double silicone tubes for treatment of canalicular obstruction. Korean J Ophthalmol. 2017;31(1):1-8.

Hurwitz JJ. A new, wider-diameter Crawford tube for stenting in the lacrimal drainage system. Ophthalmic Plastic Reconstructive Surg. 2004;20(1):40-3.

Yıldız M, Akova B, Karataş A. A New and Simple Silicone Intubation Method for Dacryocystorhinostomy. Eur J Gen Med. 2011;8(1):39-9.

Lee DH, Choi HY, Ahn JH. Comparison of results and complications between 0.64 mm and 0.94 mm silicone tube intubation in adults. J Korean Ophthalmol Soc. 2016;57(8):1193-8.

Lee SJ, Kim HY, Park YM, Lee JS. Clinical Effects of Intranasal Steroid Application after Silicone Tube Intubation in Nasolacrimal Duct Obstruction. J Korean Ophthalmol Soc. 2016;57(8):1199-204.

Chong KK, Lai FH, Ho M, Luk A, Wong BW, Young A. Randomized trial on silicone intubation in endoscopic mechanical dacryocystorhinostomy (SEND) for primary nasolacrimal duct obstruction. Ophthalmology. 2013;120(10):2139-45.

Baek BJ, Hwang GR, Jung DH, Kim IS, Sin JM, Lee HM. Surgical results of endoscopic dacryocystorhinostomy and lacrimal trephination in distal or common canalicular obstruction. Clin Exp Otorhinolaryngol. 2012;5(2):101.

Tooley AA, Klingler KN, Bartley GB, Garrity JA, Woog JJ, Hodge D et al. Dacryocystorhinostomy for acquired nasolacrimal duct stenosis in the elderly (≥80 years of age). Ophthalmology. 2017;124(2):263-7.