Primary Probing with and without Monoka Silastic Stent Intubation for Epiphora in Older Children and Adults

Purpose: To report the results of primary probing with and without monocanalicular silastic stent intubation for the relief of chronic epiphora in older children and adults and to assess its effectivity on final surgical outcome.Materials and methods: An uncontrolled surgical trial was designed. A total of 124 eyes of 102 patients (90 female, 12 male; 80 unilateral, 22 bilateral) with uncomplicated nasolacrimal ductus obstruction had primary probing with and without monocanalicular silastic stent intubation by a Ritleng probe. Symptomatic relief of epiphora and positive dye test were established as success. The time of the operation was measured, the success rate was assessed, the advantages and disadvantages were evaluated and the surgical outcome was compared with our previous papers.Results: The mean age of the patients was 37.2 years (range, 6-59) with a mean follow-up period of 14.7 months (range, 6-24). The symptoms were present for a mean of 2.5 years (range, 6 months-5 years). Of 124 eyes, 21 cases underwent only primary probing whereas the remaining 103 had primary probing with monocanalicular silastic stent intubation. The operative time was 4.3 min (range, 3-12). The silastic stents were removed between third to six months. The overall success rates at the first visit (2 weeks after stent removal) and the last visit were 58.5% and 45.2% (56 cases), respectively. None of the cases demonstrated any per- or postoperative complications. All 68 failure eyes underwent uneventful external dacryocystorhinostomy, 65 (95.5%) of which were successful with the relief of previous symptoms at final visit.Conclusions: Primary probing with or without monocanalicular silastic stent intubation may be tried initially in older children and adults with complete nasolacrimal duct obstructions, as this intervention does not prevent further possible conventional dacryocystorhinostomy in case of failure, speeds up the procedure, and avoids the disadvantages of invasive approaches.