Debates in Dacryology: The Intubation Dilemma

  • Edwin C. Figueira
  • Andrea Zarkovic
  • Simon N. Madge
  • Marcus M. Marcet
  • Dinesh Selva


The use of stenting in dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (PANDO) in the absence of canalicular disease is controversial. There is no definitive evidence to support the routine use of intubation in DCR for PANDO [1–3]. Advocates for stenting report an increased patency rate, due to presumed maintenance of canalicular and ostial patency [4, 5]. However, recent meta-analyses have not found a significant benefit from routine intubation. In addition, there are reports of a higher failure rate in DCR patients who had routine intubation for PANDO [6]. It has been suggested the higher failure rates are possibly a result of intubation-related granulomatous inflammation. Stenting of the nasolacrimal system is also associated with complications including punctal erosion and “cheese-wiring” of the canaliculi [7].


High Failure Rate Anterior Flap Silicone Intubation Nasolacrimal System Canalicular Stenosis 
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Copyright information

© Springer India 2015

Authors and Affiliations

  • Edwin C. Figueira
    • 1
  • Andrea Zarkovic
    • 2
  • Simon N. Madge
    • 2
  • Marcus M. Marcet
    • 3
  • Dinesh Selva
    • 4
  1. 1.Ophthalmic Plastics SurgeryRoyal Adelaide HospitalAdelaideAustralia
  2. 2.Department of OphthalmologyWye Valley Trust, NHSHerefordUK
  3. 3.Department of OphthalmologyUniversity of Hong KongCyberportHong Kong
  4. 4.Ophthalmology and Visual SciencesUniversity of AdelaideAdelaideAustralia

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