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In Mexico, upper lacrimal duct obstruction (ULDO) is a common pathology, and the standard surgical treatment is closed dracryointubation. Based on statistics from our headquarters, in 30% of cases there is a failure of the technique and recurrence of symptoms due to associated complications. Because of this, the application of a self-stable bicananlicular intubation set is proposed. The aim of this study is to describe the difference in efficacy and complication rate between the application of the self-stable bicanalicular intubation set II (FCI) and closed dacryointubation in patients with ULDO .
Upper lacrimal duct obstruction (ULDO) or proximal lacrimal tract obstruction occurs when an occlusion is located in the lacrimal point, in superior and inferior canaliculi, or in the common canaliculus. When the ULDO is at the level of the canaliculi (superior, inferior or common), the alternatives available for its management are closed dacryointubation with Crowford catheter, conjunctivadacryocystorhinostomy, and bicanalicular intubation.
Closed dacryointubation with Crowford tube is a technique effective in approximately 90% of children diagnosed with congenital occlusion of the lacrimal duct, however, in adults the reported surgical success rate is lower, approximately 70% according to different authors.
The conjunctivadacryocystorhinostomy is the procedure proposed by many authors when there is point and canaliculi obstruction in which canalicular intubation cannot be performed due to atresia or total obstruction.
The bicanaliculalr intubation with the Self-Stable Canalicular Intubation Set (FCI R), an FDA-approved silicone bicanalicular retention device, is especially indicated for the treatment of lacrimal point stenosis and horizontal canalicular obstruction.
The aim of this study is to describe the difference in efficacy and complication rate between the application of the self-stable bicanalicular intubation set II (ICF) and closed dacryointubation in patients with ULDO
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Closed dacryointubation | Active Comparator | Patients undergoing conventional closed dacryointubation with Crawford's tube |
|
| Bicanalicular Intubation | Experimental | Patients undergoing bicanalicular intubation with Self-Stable Intubation Set II FCI |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bicanalicular intubation | Device | Placement of the bicanalicular intubation set at each lacrimal point and fixed by means of its flaps at the level of the opening of the lacrimal sac. |
| Measure | Description | Time Frame |
|---|---|---|
| Irrigation of tha lacrimal duct | Irrigation of the lacrimal duct with saline solution to seek for permeability | three and four months after the procedure |
| Epiphora | evidence of epiphora as told by the subject | one, three and four months after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of epistaxis | postoperative bleeding throug the nose | one, three and four months after surgery |
| Presence of extrusion of bicanalicular intubation tubes | extruded or non-extruded |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institiuto de OftalmologÃa Fundación Conde de Valenciana | Mexico City | 06800 | Mexico |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | 1. Schaefer DP. Acquired Etiologies of Lacrimal System Obstructions. In: Cohen AJ, Mercandetti M, Brazzo BG, editors. The Lacrimal System [Internet]. Springer New York; 2006 [cited 2020 Jan 15]. p. 43-65. | ||
| 9893595 | Background | Fulcher T, O'Connor M, Moriarty P. Nasolacrimal intubation in adults. Br J Ophthalmol. 1998 Sep;82(9):1039-41. doi: 10.1136/bjo.82.9.1039. | |
| 454271 |
| Label | URL |
|---|---|
| characteristics of the Self-Stable Intubation Set II FCI | View source |
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Patients from the consultation of the Oculoplastics Department of the Institute of Ophthalmology "Conde de Valenciana I.A.P", between July 2021 and July 2022 who met the inclusion and exclusion criteria were enrolled
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| Closed dacryointubation | Procedure | Placement of dacryointubation tube through the canaliculus until it reaches the medial wall of the lacrimal sac and then passed the nasolacrimal duct until it empties out at the level of the inferior meatus. |
|
| one, three and four months after surgery |
| How well is the positioning of the silicone tubes | how well positioned or poorly positioned the tubes are | one, three and four months after surgery |
| Background |
| Pashby RC, Rathbun JE. Silicone tube intubation of the lacrimal drainage system. Arch Ophthalmol. 1979 Jul;97(7):1318-22. doi: 10.1001/archopht.1979.01020020060014. |
| 22259230 | Background | Tabatabaie SZ, Rajabi MT, Rajabi MB, Eshraghi B. Randomized study comparing the efficacy of a self-retaining bicanaliculus intubation stent with Crawford intubation in patients with canalicular obstruction. Clin Ophthalmol. 2012;6:5-8. doi: 10.2147/OPTH.S25172. Epub 2011 Dec 20. |
| ID | Term |
|---|---|
| D007767 | Lacrimal Duct Obstruction |
| D007766 | Lacrimal Apparatus Diseases |
| ID | Term |
|---|---|
| D005128 | Eye Diseases |
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