MAR 23, 2009
Researchers retrospectively reviewed 233 consecutive dacryocystorhinostomies (DCRs) with silicone stent placement over a four-year period to determine if employing silicone stents at the time of surgery is necessary given that there is no clinical evidence to warrant this practice.
Of the 233 cases, 42 stents extruded or had to be removed before the planned two-month period. The success rate of surgery was 90.5 percent for those who experienced early extrusion and 95.8 percent for those who did not. For those with early extrusion and a surgical failure, the mean was 15.5 days compared to 16.9 days for those with early extrusion and surgical success. The authors conclude that even though other surgeries (e.g., canalicular laceration, congenital epiphora) may benefit from intervention or reinsertion after early extrusion, the same doesn't appear true for DCR.
These results suggest that relatively early silicone stent removal after DCR may be appropriate. But two questions remain: How early can stents be removed? Are stents necessary to begin with? Ultimately, a prospective randomized study may provide definitive evidence.
Drs. Taban and Goldberg have no financial interests to disclose.