Silicone Intubation and Endoscopic Dacryocystorhinostomy: A Meta-Analysis

Objectives: During endoscopic dacryocystorhinostomy (En-DCR), bicanalicular insertion of silicone tubing into the lacrimal duct is the most common procedure to prevent the closure of the rhinostomy. It has been claimed that silicone tubing would improve the surgical outcomes of En-DCR. However, many reports revealed that without silicone intubation in En-DCR, the surgical success rate was equally high. The benefit of silicone intubation in En-DCR is controversial. Therefore, the aims of this study were to evaluate the outcome with or without the use of lacrimal silicone tubes in En-DCR and to identify whether silicone tubes after primary En-DCR are necessary. Methods: MEDLINE, EMBASE, Cochrane Library, and manual searches were conducted to identify all studies published in English between January 1, 1990, and October 30, 2009, on En-DCR with or without silicone intubation. Search terms included "endoscopic dacryocystorhinostomy" and "silicone intubation/intubing." We also reviewed references from all retrieved articles and performed a meta-analysis of the literature. Results: Of four retrieved trials from the electronic database, two trials involving 84 patients met our inclusion criteria. There was no statistically significant heterogeneity between the studies. In the fixed-effects models, the pooled risk ratio was 0.85 and the 95% confidence interval was 0.71 to approximately 1.02. Conclusion: The use of silicone tubes after primary En-DCR is not necessary.