Bicanalicular Silicone Stents in Endonasal DCR
Ophthalmology, October 2016
Fayers et al. compared the long-term success rates in endonasal dacryocystorhinostomy (EN-DCR) between surgeries performed with versus without use of a temporary silicone stent. They found a higher rate of success in the stent surgeries.
This prospective randomized controlled trial included 300 adults who underwent primary EN-DCR for nasolacrimal duct obstruction performed by the senior author of the study; 152 patients were randomized to surgery with a stent, and 148 without a stent. The primary end point was subjective symptoms of epiphora at 12 months, reported as resolved; significantly improved; partially improved; or no change or worse. The secondary, objective, end point was anatomic patency and reflux as assessed on nasolacrimal syringing.
Complete success was defined as having resolved or significantly improved symptoms of watering and minimal or no reflux on nasolacrimal syringing. Partial success was defined as symptoms partially improved with a combination of patency and reflux on syringing. Failure was categorized as no change or worse symptoms of watering and 50% to 100% reflux on syringing.
Overall success, both subjectively and objectively, was 94.7% in the stented group and 87.8% in the nonstented group (p = .034). The most common complications of stents were canalicular cheese-wiring and tube prolapse (approximately 4% each).
The authors noted that the use of tubes in EN-DCR is associated with higher cost and longer surgical time, as well as minor complications. However, they concluded that the significantly higher success rate achieved with tubes justifies their use.
The original article can be found here.