Comparison of the success rate between monocanalicular and bicanalicular intubations in incomplete complex congenital nasolacrimal duct obstruction

This article compares the success rate between monocanalicular (MCI) and bicanalicular intubations (BCI) in incomplete complex congenital nasolacrimal duct obstruction (CNLDO) and evaluate the factors responsible for the success of intubation. First, 99 patients with incomplete complex CNLDO underwent MCI (Monoka) or BCI (Crawford). Therapeutic success was defined as dye disappearance test grade 0-1 and complete resolution of previous symptoms at 12 months’ follow-up. The success rates were compared between two groups. In all cases, the correlation of the age, gender, history of probing, and the presence of purulent discharges with the improvement in CNLDO symptoms were evaluated. 52 cases in the MCI and 47 cases in the BCI group were included. Then, 48 patients (48.5%) had history of probing. 26 patients (26.3%) had purulent discharges. The patients in the MCI group had lower success rate (59.6%) than the patients in the BCI group (74.4%) but the difference was not significant (p = 0.11). No complication occurred in the BCI group. In 4 cases (7.6%) in the MCI group, the tubes were lost before time of planned removal. In all cases, only preoperative absence of the pus was significantly correlated with success (p = 0.09 and OR = 0.39). BCI may be a better treatment for the patients with incomplete complex CNLDO. In silicone intubation for these cases, preoperative absence of purulent discharges could increase the success rate.