Hassan Raza Jafri, Ashraf Dawood.
Role of Tube Manipulation in Preventing DCR Failure.
Ophthalmol Update Jan ;13(4):297-9.

Purpose:To assess the role of tube manipulation in preventing DCR failure. Methods: Consecutive case series of 28 patients. Patients were selected on non-probability purposive basis from Oculoplasty clinic, Isra Post Graduate institute of Ophthalmology from January 2012 to December 2014. All the patients with a positive regurgitation after DCR surgery and epiphora with a negative syringing test after DCR with intubation were included. Patients with DCR failure due to canalicular problems, trauma or facial malformations were excluded. Success was marked as resolution of epiphora, negative regurgitation test and a patent pathway on syringing. Complications were also noted and recorded. Results: 28 patients were included in this study out of 416 cases operated during the study period showing an overall 93.26% success rate. All patients underwent external DCR. Age of the patients range from 05 years to 72 years (mean of 32.82 years). 09 (32.14%) patients were male while 19 (67.85%) were female. Failure was prevented in 22 (28.57%) patients out of which 17 (77.27%) were females and 05 (22.72%) were males. Tube manipulation failed to restore patency in 06 (21.47%) patients out of which 02 (33.33%) were females and 04 (66.66%) were males. As far as complications are concerned, apart from 08(28.57%) failures, 05 (17.85%) patients had punctual lacerations. 03 (10.31%) patients had their lacrimal tube broken. Conclusion: Tube manipulation is an easy, simple and effective maneuver to prevent DCR failure. The surgical and economic burden of review DCR can be prevented in a large number of cases through this technique.

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