Comparative effectiveness of monocanalicular and bicanalicular silicone intubation in congenital nasolacrimal duct obstruction

Aims: This study aimed to evaluate and compare the clinical success and outcomes of monocanalicular (MCI) versus bicanalicular silicone intubation (BCI) in pediatric patients with congenital nasolacrimal duct obstruction (CNLDO). Methods: A retrospective, comparative study was conducted on 41 eyes of 41 children diagnosed with CNLDO, treated with either monocanalicular silicone intubation (MCI, n=16) or bicanalicular silicone intubation (BCI, n=25). All procedures were performed by 2 oculoplastic surgeons. Tube removal was planned for the 3rd postoperative month. Treatment success was defined as a fluorescein disappearance test of 0 and a Munk score of 0-1, 3 months after tube removal. Results: Forty-one eyes of 41 patients were analysed in 2 groups as MCI (n=16) and BCI (n=25). The mean age was 43.1±17.9 months (between 24 months and 72 months). Twenty-five (61%) of the patients were females and 16 (39%) were males. Twenty-one (51.2%) of the patients were right eyes and 20 (47.8%) were left eyes. Treatment success was achieved in 93.7% of the MCI group and 88% of the BCI group. There was no statistically significant difference between the MCI and BCI groups in terms of age, gender distribution, and laterality (p>0.05) Conclusion: Monocanalicular and bicanalicular intubation showed similar success rates in treating CNLDO. However, monocanalicular intubation provided greater tube stability and technical simplicity, making it a practical option in pediatric cases.