Follow up of Nasolacrimal Intubation in Adults
Study Details
Study Description
Brief Summary
For patients with chronic epiphora, Dacryocystorhinostomy is currently the gold standard treatment, with a success rate of 80-90% according to literature. Another available treatment, which is far less used, in nasolacrimal intubation, using a silicone tube.
In our study, we would like to find the efficacy of nasolacrimal duct intubation, which was performed in our medical center on a few hundred patients with mild epiphora.
Study hypothesis: nasolacrimal intubation in adults, with a clinically mild epiphora, is close in it's efficacy to the Dacryocystorhinostomy procedure.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
Under normal conditions, the amount of tears excreted from lacrimal glands to the eye is equal to the amount drained through the tear duct. Epiphora in adults usually involves a blockage of the lacrimal sac or the nasolacrimal duct. Epiphora causes tearing in patients, which can be treated sympthomatically in a conservative way (antibiotic treatment, probing of the tear duct, pressure irrigation of the tear duct) or therapeutic in an invasive way. The invasive treatment includes one of the following:
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Dacryocystorhinostomy - surgery for reconstructing an alternative path for tear drainage.
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Nasolacrimal intubation - inserting a silicone tube through the tear duct. The tube is usually removed after 3-6 months.
Currently, there are only a few reports regarding the efficacy of nasolacrimal intubation, all with a small number of research subjects. Also, these reports have stratified the patients according to the location of the tear duct blockage, and didn't take into account the severity of the blockage (ie the severity of symptoms) prior to performing the intubation.
In our research, we would like to find the efficacy of nasolacrimal intubation which was performed in our medical center on a few hundred patients with mild epiphora, and to compare in with the efficacy of the Dacryocystorhinostomy - which is 80-90% according to literature.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Primary All the patients in our medical center who underwent nasolacrimal intubation, due to mild epiphora, during the years 2000-2007. |
Device: Silicone tube
Silicone tube which is inserted into the tear duct through the punctum in the eyelid, then passed through the tear duct till it enters the nose and secured in place using a surgical knot. The tube remains in place for 3-6 months, than take out by the surgeon.
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Outcome Measures
Primary Outcome Measures
- Patient being completely free of tearing. [1 year.]
Secondary Outcome Measures
- Following nasolacrimal intubation, did the patient need a Dacryocystorhinostomy surgery. [1 year]
Eligibility Criteria
Criteria
Inclusion Criteria:
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Clinical diagnosis of mild epiphora.
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Underwent nasolacrimal intubation during 01/2000 - 12/2007.
Exclusion Criteria:
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Purulent excretions from nasolacrimal duct on day of admission or intubation.
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Nasolacrimal intubation in the past.
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Dacryocystorhinostomy in the past.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Maccabi Healthcare Eye Clinic | Tel Aviv | Israel |
Sponsors and Collaborators
- Shaare Zedek Medical Center
Investigators
- Study Director: Arie Nemet, MD, Shaare Zedek Medical Center, Maccabi Healthcare
- Study Chair: Arie Nemet, MD, Shaare Zedek Medical Center, Maccabi Healthcare
- Principal Investigator: Arie Nemet, MD, Shaare Zedek Medical Center, Maccabi Healthcare
Study Documents (Full-Text)
None provided.More Information
Publications
- Becker BB, Berry FD, Koller H. Balloon catheter dilatation for treatment of congenital nasolacrimal duct obstruction. Am J Ophthalmol. 1996 Mar;121(3):304-9.
- Connell PP, Fulcher TP, Chacko E, O' Connor MJ, Moriarty P. Long term follow up of nasolacrimal intubation in adults. Br J Ophthalmol. 2006 Apr;90(4):435-6.
- Crawford JS. Intubation of obstructions in the lacrimal system. Can J Ophthalmol. 1977 Oct;12(4):289-92.
- Hurwitz JJ, Rutherford S. Computerized survey of lacrimal surgery patients. Ophthalmology. 1986 Jan;93(1):14-9.
- Keith CG. Intubation of the lacrimal passages. Am J Ophthalmol. 1968 Jan;65(1):70-4.
- Pashby RC, Rathbun JE. Silicone tube intubation of the lacrimal drainage system. Arch Ophthalmol. 1979 Jul;97(7):1318-22.
- Quickert MH, Dryden RM. Probes for intubation in lacrimal drainage. Trans Am Acad Ophthalmol Otolaryngol. 1970 Mar-Apr;74(2):431-3.
- LTFNIAME