ePoster listing and sessions

Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London

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Does the Mini-Monoka tube reduce the risk of epiphora due to canalicular stenosis following medial canthal radiotherapy?

Author: Julia Sieberer
ePoster Number: 253


Although the primary treatment of periocular malignancy is mainly surgical, primary or adjuvant radiotherapy (RT) may be indicated. Post RT epiphora is commonly multifactorial, however canalicular stenosis is found in up to 100% following medial canthal RT.
Insertion of the Mini-Monoka (MM) tube into the canaliculus prior to RT may reduce the risk of canalicular stenosis and symptomatic epiphora. We report our experience of patients receiving MM tubes prior to medial canthal RT, over a 7 year period.


We carried out a retrospective case series of patients referred to the Oculoplastic Service at Musgrove Park Hospital for consideration of MM tube placement prior to medial canthal RT between 2014 and 2021. All had insertion of the MM tube prior to medial canthal RT and tubes were removed 2-3 months post RT. The MM tube was replaced if it became displaced prematurely.
We reviewed demographics and lacrimal status pre and post RT of 23 patients, 5 of which were excluded due to incomplete data. Punctal or canalicular stenosis were assessed clinically. A total of 18 patients were included and underwent descriptive statistical analysis.


The mean patient age was 72 years (50-90). All patients had insertion of the MM tube prior to and removal on average at 12 weeks (8-18) post-RT. Most patients were treated for basal cell carcinomas (n=12, 67%).
Accidental loss of the MM tube occurred in 6 patients (33%) with an average retention time of 39 days (34-124). Two patients (33%) in this group suffered from stenosis-related epiphora post RT.
12 patients (67%) retained the MM tube until planned removal for an average of 121 days (84-182). One of these patients (8%) showed stenosis-related epiphora post RT.


Our case series showed a decreased rate of stenosis-related epiphora following RT in patients who retained the MM tube for the planned duration versus the group that lost the MM tube during treatment (8% vs 33%). The MM tubes were well tolerated.
Our findings in this selective patient group compare favourably with previous studies which suggest that inserting a MM tube prior to medial canthal RT may protect the canaliculus.

Additional Authors

First nameLast nameBase Hospital / Institution
UrmilaBarthakurMusgrove Park Hospital, Somerset NHS Foundation Trust
HelenHerbertMusgrove Park Hospital, Somerset NHS Foundation Trust

Abstract ID: 21-150