A New and Simple Silicone Intubation Method for Dacryocystorhinostomy

Aim: To describe a new and simple bicanalicular silicone intubation technique, which can be used during dacryocystorhinostomy (DCR) surgery. Method: In this method, a lacrimal canula is used to pass the silicone tube through the lacrimal canaliculi. A 26-Gauge curved lacrimal canula is inserted into one end of a silicone tube with an inner diameter of 0.50 mm and outer diameter of 0.94 mm. The lacrimal puncta are enlarged using a one-snip procedure. The canula is introduced together with the tube into the punctum and advanced to the rhinostomy site. Here, the tube is detached from the canula by a forceps and the canula retracted. The other canaliculus is intubated in a similar manner. The tubes are passed out through the rhinostomy site and nose, and tied inside the nose. Result: Silicone intubation was performed in 32 DCR procedures in 30 patients (revision DCR in 13 eyes, primary DCR in 10 eyes, canalicular DCR in 7 eyes, and endonasal DCR in 2 eyes) using the described method. No significant difficulty was encountered in any case. During the follow-up, a slit punctum developed in 1 eye and prolapsus of the tube at the medial canthus in another eye; no other complication was observed. Conclusion: This method eliminates the need for retrieval of a metal leader from the lacrimal canaliculi and rhinostomy site and facilitates silicone intubation during DCR. It is a relatively nontraumatic and inexpensive method that may be an alternative to the other intubation methods.