External Dacryocystorhinostomy with Silicone stent in Anatomical and Functional primary acquired nasolacrimal duct obstruction

Purpose: To compare the benefits and complications of External dacryocysto rhinostomy (EXDCR) withSilicone tube (ST) intubation in anatomical primary acquired naso lacrimal duct obstruction (APANDO)andfunctional primary acquired naso lacrimal duct obstruction(FPANDO) patients.Materials and Methods: Patients with epiphora/discharge/mucocele are grouped into group A(APANDO) and group B (FPANDO) based on diagnostic probe test, positive syringing and FluoresceinDye Disapearance (FDD) test. Both group underwent EXDCR with ST intubation. Patients were evaluatedfor subjective and objective resolution of epiphora/discharge/mucocoele, complications and subjectivesatisfaction at the end of 6 months.Result: There were 23 patients each in group A and group B and no difference in demographic and lateralityof eye involvement. Epiphora was common presentation in FPANDO (91%) and discharge in APANDO(57%). (P =0.01). The success rate is 78.3% (18/23) in group A and 86.9% (20/23) in group B and thedifference is not significant (P=0.69). Tube related complications are high in group B 82.6% (P = 0.01)and inflammation related complications in group A 61.2% (P=0.49). In group A 82.6% (19/23) and groupB 73.9% (17/23) were satisfied with the procedure (P =0.72). Tube related complication and additionalfinancial burden are the main factors for dissatisfaction in group B (P= 0.72)Conclusion: Use of silicone tube does not alter the success rate of EXDCR in APANDO and FPANDO.Preoperative counseling and eye health educations are very important before doing such procedure on ruralpopulation.Keywords: Complications, EXDCR, PANDO, Silcone tube.