[Congenital nasolacrymal duct obstruction: pulled monocanalicular intubation (Monoka) versus pushed monocanalicular intubation (Masterka)]

Functional outcomes of canalicular laceration repair with self-retaining masterka stent in a tertiary eye care center in France: A retrospective study of 30 patients

PURPOSE

To evaluate the long-term functional outcomes of canalicular laceration repair using the Masterka® monocanalicular intubation system.

METHODS

this interventional case series included the data from 30 patients who underwent canalicular laceration repair with a 30-mm pushed monocanalicular stent (Masterka®) and suturing of the lacerated canaliculus with 8/0 Vicryl interrupted sutures. Operative details and complications were meticulously noted. Stent removal took place as early as 3 months post-surgery, with functional success defined as the absence of epiphora four years after surgery.

RESULTS

The average age of patients was 28.5±26.3 years, with 20 out of 30 patients (66.6%) being male. Lower canaliculus involvement was noted in 23 patients (76.6%), while the upper canaliculus was affected in 7 patients (23.4%). On average, patients presented for medical attention within approximately one day of sustaining with injuries, and all underwent successful repairs. Notably, functional success was observed in all 30 cases, constituting a 100% success rate. Stent-related complications were encountered in two patients (6.6%). One patient reported stent removal after an average follow-up period of one month, while the other developed a punctal granuloma one-month post-surgery, which regressed following one month of topical steroid treatment.

CONCLUSION

Repairing canalicular lacerations using the self-retaining Masterka® monocanalicular intubation system demonstrated a notable achievement in long-term functional success while presenting minimal complications. To further substantiate these promising results, an interventional study that includes a comparison analysis with other types of intubation methods is warranted.

Pulled versus Pushed Monocanalicular Silicone Intubation in Adults with Lacrimal Drainage System Stenosis: A Comparative Case Series

Purpose

To compare the success rate and complications of pulled versus pushed monocanalicular intubation in adults with incomplete lacrimal drainage system obstruction (lacrimal drainage system stenosis).

Methods

Patients with lacrimal drainage system stenosis (Munk grade ≥3), including both nasolacrimal duct (NLD) stenosis and common canalicular stenosis, were recruited in this prospective comparative case series. Patients underwent probing and either Monoka (51 eyes) or Masterka (48 eyes) intubation under general or local anesthesia. Tubes were removed 4–14 weeks after the procedure. Six months after tube removal, Munk grades 0 and 1 were defined as a complete success, Munk grade 2 was defined as a partial success, and Munk grade ≥3 was defined as failure. All complications were recorded.

Results

Ninety-nine eyes from 89 patients with lacrimal drainage system stenosis who underwent either Monoka (51 eyes) or Masterka (48 eyes) intubation were included. The mean (SD) age of the patients was 55.4 (12) years in the Monoka group and 53.5 (12.9) in the Masterka group. Groups were matched on demographics. Masterka intubation could not be performed in one eye. Complete and partial successes were observed in 52.9% (27/51) and 17.6% (9/51) of eyes in the Monoka group and 42.6% (20/47) and 12.8% (6/47) of eyes in the Masterka group, respectively (p=0.29). There was a trend toward a higher total success rate in patients with NLD stenosis treated with Monoka 66.7% (26/39) than Masterka 45.5% (15/33) intubation (p=0.07). This trend also existed in patients with common canalicular stenosis (83.3% (10/12) vs. 76.6% (11/14), p=0.75). Age, sex, bilateral involvement, and duration of intubation did not have a significant impact on the success rate. Early tube loss, slit puncta, and temporary superficial punctate keratopathy were observed complications.

Conclusion

Intubation with the pulled monocanalicular silicone tube was associated with a slightly but not significantly higher success rate in adults with lacrimal drainage system stenosis. Patients with NLD stenosis may achieve better results with pulled silicone tubes.