Complications of Delayed Tube Removal after Dacryocystorhinostomy Surgery in the COVID Era

Abstract

Purpose: A silicon stent intubation, done after Dacryocystorhinostomy (DCR) surgery, is generally removed after 6 weeks. However COVID-19 related lockdown as well as recommendation to hold the lacrimal procedures for safety related purpose had led to delay in silicon tube removal for many months. Side effects of even short term silicon stenting are well known. The purpose of this study was to assess the complications of delayed stent removal after DCR surgery, due to COVID restrictions. Materials and Methods: A cross sectional study that included 35 post DCR patients whose silicon tube removal was delayed due to COVID restrictions, was done. Detail history and clinical examination to note the DCR surgery and tube related complications were noted. Silicon tube was removed and syringing done where possible. Result: Mean age was 41 years (SD 14.3; range 7-68 years). Among them, 29(83%) were females. The most common presenting symptom was persistent watering in 19 patients (54.2%); however syringing was found to be patent in 30 patients (85.7%). Out of 35 eyes, 26 (74.3%) had the silicon tube in situ in normal position without puncta or canaliculus complications. The mean (SD) time of delay in tube removal after DCR surgery was 9.5 (2.9) months. The average (SD) delay time in months of study participants who had complications and without complications were 8.3 (2.7) and 10 (2.8) respectively, which was not statistically significant. Conclusion: Delay in silicon tube removal is a safe practice in COVID era.