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Does the Timing of Silicone Tube Removal Following External Dacryocystorhinostomy Affect Patients' Symptoms?

Aims: To investigate whether the timing of silicone tube removal after external dacryocystorhinostomy (EXT-DCR) for lacrimal outflow obstruction affects outcome. Methods: Retrospective chart review and follow-up by telephone survey of 205 consecutive patients undergoing EXT- DCR. Long-term success was evaluated by telephone survey. Results: Full data was collected in 180 out of 205 DCRs. Ninety four tubes (52.3%) were removed routinely between 2 and 4 months after surgery, 24 tubes (13.3%) were removed before the planned 2-month period and 62 tubes (34.4%) were removed after the planned 4-month period. The three groups (early, routine and late) were comparable in terms of age, gender distribution, mode of anaesthesia, proportion of repeat EXT-DCRs and seniority of surgeon. The mean follow-up period was 3 years and 10 months. One hundred and twenty-eight of the 155 patients (82.5%) were contactable by phone. In the routine tube removal group, at the time of follow-up, 65.1% experienced complete symptom resolution, 25.4% experienced partial symptom resolution, 6.3% experienced no symptom resolution and 3.2% experienced worse symptoms. In the early tube removal group, at the time of follow-up, 63% experienced complete symptom resolution, 32% experienced partial symptom resolution and 5% experienced no change in symptoms. In the late tube removal group, at the time of follow-up, 70% experienced complete symptom resolution, 21.5% experienced partial symptom resolution and 8.5% experienced no symptom resolution. There was no statistically significant difference in the outcome of the three groups. Conclusions: Our experience and this study suggest that timing of silicone tube removal does not influence surgical success in EXT-DCR regardless of the cause of early or late tube removal.