Silicone nasolacrimal intubation: our experience in long term cases

Purpose: To evaluate the bicanalicular tube structural integrity and the anatomical and functional post operative results of cases of long and very long bicanalicular intubation (from 2 to 13 years). Methods: We studied all the patients of our Department with long-lasting intubation (greater than one year), from 2000 to 2021. We obtained an histocytological evaluation of the material of intubation and a nasal endoscopy. We investigated the causes of the long permanency and the patient tolerability. Results: In our study, 6 eyes from 5 patients (4 women and 1 man) underwent a nasolacrimal duct intubation. The mean intubation permanency time was 6.8 years and the median value was 7 years (minimum 2 years, maximum 13 years). The bicanalicular tube examinations found traces of mucus made of amorphous protein material, sporadic leukocytes and histiocytes. In all the patients the nasal endoscopy showed good conditions of the middle meatus mucosa. Conclusions: In complex cases, such as multiple re-operations, inflamed and small lacrimal sac, fibrotic sac, inflamed nasal mucosa for previous nasal pathologies, a permanent silicone tube could be a reasonable choice as it appears to be well tolerated and without major complication risks.