Clinical Ophthalmology (Mar 2020)
Bicanalicular Intubation with the Kaneka Lacriflow for Proximal Lacrimal Drainage System Stenosis
Abstract
Sarah W DeParis,1,2 Clarinda J Hougen,1 Fatemeh Rajaii,1 Nicholas R Mahoney1 1Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA; 2Department of Ophthalmology, The Permanente Medical Group, San Rafael, CA, USACorrespondence: Nicholas R MahoneyDepartment of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USATel +1 410 955 1112Fax +1 410 614 9987Email [email protected]: The Kaneka Lacriflow CL (Lacriflow) bicanalicular lacrimal intubation system was evaluated as a self-retaining alternative to traditional modalities for stenting and dilation of the lacrimal drainage system in proximal lacrimal drainage system stenosis.Patients and Methods: A retrospective chart review was conducted to assess the use of the Lacriflow system for treatment of patients with punctal and canalicular stenosis. Anesthesia type, operative time, and complications were assessed.Results: In the time period evaluated, a total of 72 Lacriflow stents were placed in 45 patients, most commonly under intravenous sedation. Stents were left in place for a mean of 145 days, with 9 stents left in place for more than 1 year, and a mean follow-up time of 263 days. Early complications within 90 days included prolapse in 1 stent, symptomatic colonization for 2 stents, and corneal abrasion in 1 stent in a patient with anterior basement membrane dystrophy. Five additional stents developed colonization in the late postoperative period (four of which were more than 1 year after stent placement). The overall complication rate (per stent) at 3 months after surgery was 5.6% and at all follow-up time points was 13.9%. Operative times were significantly shorter for a cohort of patients undergoing bicanalicular intubation with the Ritleng system (P = 0.015).Conclusion: The Lacriflow bicanalicular stent can be easily placed without general anesthesia. Complication rates are comparable to other bicanalicular intubation systems, but increase with longer time that stents are left in place.Keywords: bicanalicular intubation, canalicular stenosis, punctal stenosis, Lacriflow, silicone intubation
