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Early stent extrusion may not hinder success of external DCR, study suggests
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Early stent extrusion or removal after external dacryocystorhinostomy may not be as detrimental as previously thought, a retrospective study suggests. Furthermore, longer stent retention and reintubation after early extrusion do not appear to yield a higher success rate.
"Although there are less rigorous designs requiring fewer resources that could be proposed, the need for a high-quality definitive study on this topic suggests that a large prospective randomized study may be needed to determine if the use of a silicone stent is in fact advantageous for all [dacryocystorhinostomies]," the study authors said in the July issue of Ophthalmology.
Matthew G. Vicinanzo, MD, and colleagues at the University of Alabama in Birmingham evaluated the clinical effects of premature silicone stent loss in 233 cases that underwent primary external dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction.
Duration of follow-up, age, gender, number of days until stent removal and success of surgery were recorded during follow-up appointments at 1 week, 2 months and 6 months postop. The investigators identified all cases in which the silicone stent was extruded before a predetermined 2-month period.
Forty-two stents (18%) were extruded or had to be removed before the 2-month period, the authors noted.
The surgical success rate for the entire cohort was 94.9%. The success rate for patients who had early extrusion was 90.5%; the success rate for patients who did not lose stents prematurely was 95.8% (P = .24), according to the study.
Of the four patients with a failed surgery, none had a recurrent infection or pain. Only one of the four patients elected to undergo surgical revision.
"Patient age, gender or timing of the extrusion was not found to affect surgical success significantly," the authors said.