outcomes of external dacryocystorhinostomy without intubation versus monocanalicular intubation in primary acquired nasolacrimal duct obstruction

purpose: to compare success rates of external dacryocystorhinostomy (dcr) with and without bicanalicular silicone intubation for management of primary acquired nasolacrimal duct obstruction. methods: in a randomized clinical trial study, 52 patients with primary acquired nasolacrimal duct obstruction underwent external dcr. patients were randomly enrolled into two groups. in the 1st group, external dcr was performed without intubation and in the 2nd one, monocanalicular intubation was used. all patients were followed for at least 3 months. subjective and objective signs were evaluated by munk score and irrigation & aspiration respectively. demographic data such as age, gender, subjective and objective success were collected and analyzed. results: overall, 26 eyes were enrolled in each group. mean age of patients was 44.5±18.5 years in the monocanalicular silicone intubation group and 48.3±21.2 years in the group without intubation, (p= 0.502). success in group one (without intubation) was achieved objectively in 24 of 26 eyes (92.3%) and subjectively in 25 of 26 eyes (96.1%) compared to 22 of 26 eyes (84.6%) and 24 of 26 eyes (92.3%) in the monocanalicular silicone intubation group (p=0.5). mean follow-up was 7.2±2.5 in group one and 7±2.2 in group two (p=0.76). conclusion: although external dacryocystorhinostomy without intubation had marginally higher success rates, this difference is not statistically significant. it seems that surgeon’s experience and surgical techniques play the main role irrespective of performing intubation.