Treatment for functional failure after primary endonasal dacryocystorhinostomy

Purpose: To analyze the results of secondary silicone tube insertion in patients exhibiting persistent epiphora despite acquiring anatomical patency after primary endonasal dacryocystorhinostomy. Methods: We conducted a retrospective review of 23 patients (37 eyes) seen at our department from December 2006 to April 2018 for primary endonasal dacryocystorhinostomy. These patients exhibited anatomical patency but experienced persistent epiphora, requiring secondary silicone tube re-insertion. Results: The average age at reintubation with a silicone tube was 59.8 years, and the average follow-up was 14.8 months. The interval between the primary endonasal dacryocystorhinostomy and secondary silicone tube re-insertion was approximately 24.5 months. The silicone tube re-insertion, was successful for 33 of 37 eyes with four eyes exhibiting partial improvement. Thus, there were no failed outcomes based on subjective symptoms. Conclusions: After primary endonasal dacryocystorhinostomy, when tearing symptoms persist despite no evidence of anatomical problems, our results show that secondary silicone tube re-insertion is a safe and effective procedure for patients experiencing functional failure.