Sutured Ritleng tube intubation for congenital nasolacrimal duct obstruction: Large retrospective analysis

This study evaluates the application and clinical efficacy of sutured Ritleng silicone tube intubation in children with congenital nasolacrimal duct obstruction (CNDO). A retrospective review was conducted on 561 eyes of 463 patients who underwent Ritleng tube intubation due to nasolacrimal duct obstruction. Patients were divided into 2 groups as those who had previously undergone probing (Group 1) and those who underwent Ritleng primarily (Group 2). The silicone tube with prolene guide was removed from the inferior meatus and fixed to the nasal side wall with a 6/0 prolene suture. Resolution of signs and symptoms of lacrimal obstruction was evaluated. The mean follow-up period for both groups was 4.36 ± 1.4 and 4.58 ± 1.7, respectively. Silicone tubes were successfully placed in all eyes. The average surgical time for each eye was 12 minutes (range, 10-25 minutes). The silicone tube with the Prolene guide spontaneously exited the nose in 80 eyes (14.26%). Those that did not spontaneously exit were removed with a blunt-ended hook. In 25 (6%) of eyes, the tube was accidentally dislodged and had to be removed early. Success, improvement rates of signs and symptoms were 100% and 98% in both groups, respectively. The Ritleng intubation method provides a high success rate for CNDO. Considering the high number of cases and the success rate, suture-fixed silicone tube intubation appears to be an effective treatment method for CNDO.