Early Versus Standard Timing For Silicone Stent Removal Following External Dacryocystorhinostomy Under Local Anaesthesia

Financial Interest: nil Conflict of Interest: nil Received: 02.06.2019 Accepted: 16.06.2019 Corresponding author Dr. Aashish Raj Pant, MD Ophthalmic Plastic Surgery and Ocular Oncology Department Mechi Eye Hospital, Jhapa, Nepal Email: aashishrajpant@gmail.com, aashish_pant@hotmail.com and facilitating the passage of the tears along the walls of the stent by capillary mechanism. Lacrimal intubation has traditionally been advocated in cases where there are increased chances of fibrosis and subsequent failure of the surgery. Indications for lacrimal intubation during external DCR may be preoperative or intraoperative. Preoperative factors include young age, repeat DCR surgery, traumatic NLDO, distal canalicular and common canalicular obstruction. Intraoperative factors include excessive bleeding during surgery, inability to create mucosal anastosmosis, inadequate or improper mucosal anastosmosis, thin or atrophic lacrimal flaps likely to dehiscence, etc. Punctal cheese wiring due to tight intubation, spaghetti sign with corneal erosion by silicone tube due to loose intubation and foreign body reaction to the silicone material are the main complications of lacrimal silicone tube intubation.