The results of Ritleng bicanalicular silicone intubation for congenital and adult partially acquired nasolacrimal duct obstruction

OBJECTIVE: Our aim was to evaluate the long-term results of Ritleng bicanalicular silicone intubation for congenital and adult partially acquired nasolacrimal duct (NLD) obstruction.
METHODS: We evaluated 28 eyes of the 26 patients treated with lacrimal intubation with the Ritleng method retrospectively. Patients were divided into two groups. Patients with congenital NLD obstruction (n: 16) constituted Group 1 and patients with adult partially acquired NLD obstruction (n: 10) constituted Group 2. The Ritleng probe was inserted from the canaliculus into the inferior meatus. Success was defined within two parameters: (1) Intubation of the silicone tube without complications and (2) recovery of the previous signs and symptoms and a normal fluorescein dye test.
RESULTS: Mean of the patients’ ages was 2.4±1.6 years in Group 1 and 49±15 years in Group 2. The intubation was successful in all of the patients (100%) in Group 1, meanwhile in Group 2, false passage was observed in 2 patients (20%). Silicone tube was removed through the punctum in outpatient clinic conditions between 2 weeks and 3 months (mean: 2.1 months) in Group 1 and 4–6 months (mean: 5.2 months) in Group 2. Patients in Groups 1 and 2 were followed for 26±18.6–36±25 months, respectively. Previous signs and symptoms were recovered in 75% of the patients in Group 1 and the dye tests of these patients were normal. In Group 2, only two patient’s symptoms were resolved (20%). For the adult patients whose symptoms were not resolved, an external dacryocystorhinostomy operation was performed.
CONCLUSION: The Ritleng lacrimal intubation system is an effective procedure for the treatment of congenital NLD obstruction for both short and long term. On the other hand, the effectiveness of the procedure is limited for the adult partially acquired NLD obstruction.

Doðumsal ve yetiþkin kýsmi edinsel nazolakrimal kanal týkanýklýðýnda Ritleng bikanaliküler entübasyonu sonuçlarýmýz

AMAÇ: Doðumsal ve yetiþkin kýsmi edinsel nazolakrimal kanal (NLK) týkanýklýðýnda Ritleng bikanaliküler silikon entubasyonun uzun dönem sonuçlarýnýn deðerlendirilmesi.
GEREÇ VE YÖNTEM: Ritleng metodu ile lakrimal entubasyon yapýlan 26 hastanýn 28 gözü retrospektif olarak incelendi. Hastalar iki gruba ayrýldý. Doðumsal NLK týkanýklýðý olan hastalar (n: 16) Grup 1’i ve yetiþkin kýsmi edinsel NLK týkanýklýðý olan hastalar (n: 10) Grup 2’yi oluþturdu. Ritleng probu kanaliküllerden alt meatusa geçirildi. Baþarý iki parametre ile deðerlendirildi: 1.Komplikasyonsuz olarak silikon tüp entübasyonu, 2. Daha önceki belirti ve bulgularýn tamamen düzelmesi ve normal flöresein boya testi.
BULGULAR: Hastalarýn yaþ ortalamalarý Grup 1’ de 2,4±1,6 yýl, Grup 2’de 49± 15 yýl idi.
Grup 1’de entübasyon tüm gözlerde baþarýlý idi (%100), Grup 2’de 2 hastada yanlýþ pasaj gözlendi (%20). Silikon tüp, Grup 1’de 2 hafta ile 3 ay arasýnda (ortalama 2,1 ay) ve Grup 2’de 4 ile 6 ay arasýnda (ortalama 5,2 ay) poliklinik þartlarýnda punktumdan çýkarýldý. Hastalar Grup 1 ve 2’de sýrasýyla ortalama 26± 18,6 ve 36 ±25 ay takip edildi. Daha önceki belirti ve bulgular Grup 1’de vakalarýn % 75’inde düzeldi ve boya testi bu olgularda normal idi. Grup 2’de ise vakalarýn sadece iki tanesinde semptomlarda düzelme gözlendi (%20). Düzelme gözlenmeyen yetiþkin hastalara (%80) eksternal dakriyosistorinostomi operasyonu yapýldý.
SONUÇ: Ritleng lakrimal entubasyon sistemi, doðumsal nazolakrimal kanal týkanýklýðýnda erken ve uzun dönemde etkili bir yöntemdir. Yetiþkin kýsmi NLK týkanýklýðýnda ise etkinliði sýnýrlýdýr. (NCI-2020-0358.R1)