title: Silicone intubation for the treatment of epiphora in adults with presumed functional nasolacrimal duct obstruction.
abstract: OBJECTIVE
  To evaluate the long-term efficacy of silicone intubation in adults with presumed functional nasolacrimal duct obstruction.
  
  
  METHODS
  This retrospective cohort study reviewed adults with unilateral or bilateral epiphora and presumed functional nasolacrimal duct obstruction treated with silicone intubation and followed for signs of treatment failure (defined as persistent epiphora or need for a secondary procedure). Median time to event (failure) after silicone intubation was calculated using Kaplan-Meier survival analysis. Analysis was conducted at the level of the individual eye, with clustering by person taken in account. Cox proportional hazards models were used and adjusted for within-subject variance using a robust sandwich estimator.
  
  
  RESULTS
  Forty-four eyes from 30 patients with isolated functional nasolacrimal duct obstruction underwent silicone intubation for epiphora. Mean time to stent removal in 40 of 44 eyes was 4.0 (±4.1) months. Mean duration from the time of stent placement to last follow-up was 2.6 (±2.0) years. Overall success after silicone intubation for resolution of symptoms was 77%. Kaplan-Meier survival analysis for time to event after silicone intubation yielded a median time of 5.7 years. Extrapolated data demonstrated a 96% success rate at 2 years and 85% success rate at 3 years and predicted approximately 50% of patients to have relief of epiphora between 5 and 6 years after silicone intubation.
  
  
  CONCLUSIONS
  In this study, silicone intubation has good long-term success for relief of epiphora in patients with presumed functional nasolacrimal duct obstruction. This study provides important clinical information to guide management of epiphora in adults with functional nasolacrimal duct obstruction.
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, California, USA. MoscatoE@vision.ucsf.edu
authors.forename: Eve E
authors.initials: EE
authors.lastname: Moscato
authors.forename: Angela M
authors.initials: AM
authors.lastname: Dolmetsch
authors.forename: Rona Z
authors.initials: RZ
authors.lastname: Silkiss
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Seiff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007440:Intubation / Q000379:methods*; D007766:Lacrimal Apparatus Diseases / Q000628:therapy*; D007767:Lacrimal Duct Obstruction / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct; D012826:Silicone Elastomers / Q000008:administration & dosage*; D015607:Stents; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D012826:Silicone Elastomers