Endoscopic dacryocystorhinostomy with and without silicone intubation in primary acquired nasolacrimal duct obstruction: a comparative study

To observe the clinical efficacy of endoscopic dacryocystorhinostomy (EN-DCR) with and without silicone intubation in treating primary acquired nasolacrimal duct obstruction (PANDO). This retrospective study enrolled 115 PANDO patients. The patients were divided into two groups based on the treatment modalities they received. Group 1 comprised 61 patients who underwent EN-DCR without silicone intubation, while Group 2 consisted of 54 patients treated with EN-DCR combined with silicone intubation. Clinical outcomes were analyzed to assess treatment efficacy. This study included 115 PANDO patients, 61 in Group 1 and 54 in Group 2. Baseline demographics and tear film parameters had no significant differences between the two groups preoperatively. Postoperatively, no significant differences were observed in tear film parameters, including tear film breakup time (BUT), lacrimal river height (LRH), and tear meniscus area (TMA) between the two groups. In addition, recurrence and complication rates did not differ significantly between the two groups. However, there was a significant difference in postoperative curative effect between the two groups. Group1 demonstrated superior results at 1-month follow-up postoperative (19.67% cure rate vs. 7.41% in Group2; P = 0.03), while Group2 showed better outcomes at 6-month follow-up (68.52% cure rate vs. 49.18% in Group1; P = 0.04). Additionally, Group 2 achieved significantly lower Munk scores at 6 months (P < 0.001). This study demonstrates that EN-DCR is effective and safe for PANDO with or without silicone intubation. Notably, our findings clarify intubation’s role: EN-DCR without silicone intubation was associated with better outcomes at the 1‑month follow‑up, whereas the intubation group showed more favorable results at 6 months. This guides personalized decisions, bridging research and practice to optimize care.