Lacrimal Intubation

Lacrimal intubation involves insertion of a silicone stent into the lacrimal outflow system to restore its patency and prevent secondary stenosis. Over the years, a variety of organic, metal composites, and synthetic stent materials have evolved, with silicone being a nearly ideal intubation material because of its relative flexibility, durability, and biocompatibility. Lacrimal intubation devices are divided into two types: monocanalicular and bicanalicular stents. Stents are also classified as 'pulled' or 'pushed.' In contrast to traditional ‘pulled’ stents, which require intranasal retrieval of the bodkin attached to the end of the tube, a ‘pushed’ stent is placed with a probe guide that is retracted from the stent lumen during intubation. The lacrimal intubation procedure consists of three steps: lacrimal probing, retrieval of the introducer, and fixation of the tubes. The outcome of a lacrimal intubation may be influenced by the indication for treatment, the level and extent of stenosis, type and duration of intubation, biocompatibility of the tubes, and post-operative complications. Congenital nasolacrimal duct obstruction, canalicular stenosis, trauma repair, and reconstructive procedures are the main indications.