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Ritleng method of intubation appears effective for nasolacrimal duct obstruction
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The Ritleng method of intubation appears to be an effective treatment for pediatric congenital nasolacrimal duct obstruction, a study found.
Bülent Yazici, MD, and colleagues at the Uludag University in Bursa, Turkey, evaluated the method for bicanalicular silicone intubation on 50 eyes of 42 consecutive children with a mean age of 37.3 months. All patients had congenital nasolacrimal duct obstructions.
Surgeons inserted a hollow Ritleng probe into the inferior meatus via the canaliculus, and advanced through the probe a Prolene thread-guide, which was attached to the silicone tube. Once the thread-guide emerged from the nose, surgeons sutured the tube ends to the nose wall.
At a mean 18.1 months' follow-up, 86% of eyes achieved symptom relief, although 21% of eyes required early tube removal due to inadvertent dislodgement, according to the study.
The Prolene guide spontaneously emerged during surgery in only eight eyes (16%) and had to be retrieved with a hook for all other cases. "Contrary to previous reports, our experience suggests that the surgeon must be prepared to retrieve the prolene guide from the nose," the authors said.
The study is published in the August issue of the Journal of the American Association for Pediatric Ophthalmology and Strabismus.