Follow up of Nasolacrimal Intubation in Adults

Study Overview
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Brief Summary
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For patients with chronic epiphora, Dacryocystorhinostomy is currently the gold standard treatment, with a success rate of 80-90% according to literature. Another available treatment, which is far less used, in nasolacrimal intubation, using a silicone tube. In our study, we would like to find the efficacy of nasolacrimal duct intubation, which was performed in our medical center on a few hundred patients with mild epiphora. Study hypothesis: nasolacrimal intubation in adults, with a clinically mild epiphora, is close in it's efficacy to the Dacryocystorhinostomy procedure.

Detailed Description
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Under normal conditions, the amount of tears excreted from lacrimal glands to the eye is equal to the amount drained through the tear duct. Epiphora in adults usually involves a blockage of the lacrimal sac or the nasolacrimal duct. Epiphora causes tearing in patients, which can be treated sympthomatically in a conservative way (antibiotic treatment, probing of the tear duct, pressure irrigation of the tear duct) or therapeutic in an invasive way. The invasive treatment includes one of the following: Dacryocystorhinostomy - surgery for reconstructing an alternative path for tear drainage. Nasolacrimal intubation - inserting a silicone tube through the tear duct. The tube is usually removed after 3-6 months. Currently, there are only a few reports regarding the efficacy of nasolacrimal intubation, all with a small number of research subjects. Also, these reports have stratified the patients according to the location of the tear duct blockage, and didn't take into account the severity of the blockage (ie the severity of symptoms) prior to performing the intubation. In our research, we would like to find the efficacy of nasolacrimal intubation which was performed in our medical center on a few hundred patients with mild epiphora, and to compare in with the efficacy of the Dacryocystorhinostomy - which is 80-90% according to literature.

Official Title
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Long Term Follow up of Nasolacrimal Intubation in Adults With Mild Epiphora

Conditions
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Lacrimal Apparatus Diseases, Dacryocystitis

Intervention / Treatment
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* Device: Silicone tube


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of mild epiphora. Underwent nasolacrimal intubation during 01/2000 - 12/2007. Exclusion Criteria: Purulent excretions from nasolacrimal duct on day of admission or intubation. Nasolacrimal intubation in the past. Dacryocystorhinostomy in the past.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Primary<br>All the patients in our medical center who underwent nasolacrimal intubation, due to mild epiphora, during the years 2000-2007. | Device: Silicone tube<br>* Silicone tube which is inserted into the tear duct through the punctum in the eyelid, then passed through the tear duct till it enters the nose and secured in place using a surgical knot. The tube remains in place for 3-6 months, than take out by the surgeon.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient being completely free of tearing. |  | 1 year. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Following nasolacrimal intubation, did the patient need a Dacryocystorhinostomy surgery. |  | 1 year |