Abstract Listings 2025

Purpose

To present two intubation techniques for endoscopic lacrimal duct recanalization (ELDR) using a dacryoendoscope and self-retaining bi-canalicular stents in children with congenital lacrimal duct obstruction (CLDO), and to report surgical outcomes.

Methods

From 2014 to 2024, ELDR followed by intubation was performed under general anesthesia in 194 eyes of 156 children (≤8 years old, 88 boys, mean age 33±19 months) with CLDO (excluding syndromic cases) at Kanagawa Children’s Medical Center. A 0.9-mm curved-tip dacryoendoscope (Fibertech Co. or Machida Endoscope Co., Tokyo, Japan) was used, and stenting was performed with Lacrifast® (ROHTO Nitten Co., Osaka, Japan). Following recanalization, intubation was achieved using either direct stent intubation (DSI) or Goto’s sheath-guided intubation (G-SGI), in which an 18-gauge intravenous catheter (sheath) was fitted over the endoscope and used as a guide for stent insertion after scope removal. A combined method (DSI via upper punctum and G-SGI via lower) was also employed.

Results

DSI was used in 29 eyes, G-SGI in 106, and the combined method in 59. Intubation was successful in all cases (100%). Stents were removed in an outpatient setting after approximately one month (mean 35±17 days). Early removal occurred in 29 eyes (14.9%) but all showed resolution. No significant complications related to stent placement were observed. All cases achieved resolution without the need for dacryocystorhinostomy (DCR).

Conclusion

ELDR followed by intubation with a dacryoendoscope and self-retaining bi-canalicular stents is a safe and effective procedure for treating pediatric CLDO.

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