Long-term placement of silastic nasolacrimal tubes

We retrospectively reviewed the complication rate associated with silastic tube intubation in the treatment of congenital and acquired obstructions of the lacrimal system in 82 patients with a follow-up of 3 to 66 months. Complications included tube prolapse, extrusion or breakage, punctal erosion, conjunctival irritation, intranasal discomfort, and tube inspissation with mucoid debris ("dirty tubes"). The rate was highest in the first 3 months (41%); it decreased to less than 10% after 6 months. Based on these findings, we recommend that silastic nasolacrimal tubes be regarded as semi-permanent devices which may safely be left in place for years.