Repositioning of the completely prolapsed lacrimal tube after bicanalicular intubation: a novel technique.

Abstract

Purpose: To evaluate the outcomes of a novel technique for repositioning a completely prolapsed lacrimal tube after bicanalicular intubation for congenital nasolacrimal duct obstruction.

Methods: This retrospective study included 18 children with complete lacrimal tube prolapse that could not be repositioned from the nose during the period from July 2020 to August 2023. Medical records were reviewed for demographic data, date and details of the initial intubation surgery, and the time till tube prolapse was calculated. Description of the repositioning procedure including the duration, intraoperative complications and success rate were reported. Postoperative follow-up visits were scheduled weekly for 1 month then monthly till tube removal to record tube stability and any postoperative complications. After tube removal, follow up was continued for 3 months to detect recurrent epiphora.

Results: 18 eyes of 18 children were included with a mean age of 1.36 ± 0.24 years. Mean time till tube prolapse was 23.6 ± 17.1 days. The success rate of the novel repositioning technique was 83.3%. The mean duration of the procedure was 11.8 ± 1.8 min. 2 (13.3%) cases had mild intraoperative nasal bleeding that did not prevent repositioning. No other intraoperative complications were reported. Postoperatively, 2 (13.3%) children showed recurrent partial tube prolapse.

Conclusion: The novel repositioning technique is safe and effective in children with complete tube prolapse after bicanalicular intubation. It salvages the existing tube avoiding the added cost and burden of a new intubation. Trial registration ZU-IRB#11052-13-9-2023, 13/9/2023 'retrospectively registered'.