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Updated: Jun 22, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Prospective randomised comparison of external dacryocystorhinostomy with and without silicone intubation
R Saiju1, L J Morse, D Weinberg
1Tilganga Eye Centre, Kathmandu, Nepal. rsaiju@tilganga.com.np
Background/Aims:
The aim of the study was to compare surgical outcomes of external dacryocystorhinostomy (DCR) with and without silastic intubation for treatment of primary uncomplicated nasolacrimal duct obstruction (NLDO).
Design:
The study was a prospective randomised trial conducted at the Tilganga Eye Centre (Kathmandu, Nepal).
Methods:
One-hundred consecutive patients with uncomplicated primary NLDO were randomly assigned into two groups (44 underwent DCR with silastic intubation and 56 underwent DCR without intubation). Patients were re-assessed at 1 week, 6 weeks and 6 months after surgery. Success was defined objectively by irrigation of the puncta without regurgitation and subjectively by the absence of epiphora or discharge.
Results:
The success rate at 6 months was 90% for DCR with silastic intubation and 87% for DCR without silastic intubation. There was no statistically significant difference between the two groups (p = 0.77). No complications were encountered in either group. Silicone tubes increased surgical cost by 20% at the Tilganga Eye Centre.
Conclusion:
DCR without silastic intubation is less expensive than DCR with silastic intubation in primary uncomplicated NLDO, and has a similar success rate. DCR with silastic intubation may create increased burden for patients in the form of more post-surgical follow-up visits. In cases of uncomplicated primary NLDO, the use of silastic intubation in DCR may be unnecessary.
