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Whether to routinely intubate or not in dacryocystorhinostomy (DCR) surgery has been a subject of controversy among lacrimal surgeons. Similarly, if intubated the timing of removal of stent is not standard. Here, the authors carried out a survey of their consecutive adult patients treated with external DCR with one week silicone stent intubation. Seventy cases of primary external DCR (67 patients) with one week intubation were included in the study and a questionnaire was sent to 63 patients (66 cases) four years post-surgery asking them to grade the frequency of current epiphora problems as never / seldom or often / constant in the operated eye. Patients categorising their symptoms as often / constant were offered a follow-up visit. All patients had bicanalicular silicone stent intubation which was taped to nasal ala and was removed along with skin sutures at one week follow-up. Response rates to the questionnaire were 88% (58 cases). In 54 cases (93%) epiphora was classified as never / seldom and in four cases as often / constant. Of the four patients, one declined further examination, two had anatomically patent tear ducts with coexisting functional epiphora and one had multiple adherences on both sides of nasal septa needing ENT referral. Based on this, excluding the non-responders and one deceased patient, the authors concluded functional or anatomical success rate as 97%. The authors acknowledge the limitations, such as not all patients were re-examined and the study being non-comparative. They discuss short intubation time is cost-effective and practical as it eliminates the need for a second routine follow-up visit.

One-week intubation in external dacryocystorhinostomy – a report on long-term outcome.
Bohman E, Kopp ED.
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Rina Bhatt

Wolverhampton Eye Infirmary, UK.

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