The experience with Ritleng intubation system in patients with congenital nasolacrimal duct obstruction

To report the clinical experience and success rate with Ritleng intubation system in patients with congenital nasolacrimal duct obstruction.

Twenty-four patients (32 eyes) with congenital nasolacrimal duct obstruction treated with the Ritleng intubation system were enrolled in this study. The mean age was 20.1+/-9.6 months. The technique involved introduction of a Prolene monofilament guide thread, securely fastened to silicone tubing, into a tubular metal probe that opened into the inferior meatus. Success was defined as complete resolution of previous symptoms and a normal result of dye disappearance test in cooperative patients. To establish relationship of success rate with patients' ages, these data were compared and analyzed.

All eyes were successfully intubated with the Ritleng system. The Prolene monofilament spontaneously emerged from the nose in 19 (60%) of 32 eyes, making retrieval simple and uncomplicated. The overall success rate (of all aged groups) was 90%. In the group over 24 months of age, there was no significant decrease in the success rate (p > 0.1), but obvious difficulty in intubation and lengthy operation time were noted.

Silicone intubation with the Ritleng system is an effective treatment for patients with congenital nasolacrimal duct obstruction, especially at young age. Comparing with conventional metal probe system, there was minimal nasal bleeding and trauma to the nasal mucosa with Ritleng intubation system. With the advantage of easy retrieval, operation time can be shortened, thereby improving patient care and decreasing potential morbidity.