Comparing outcomes of Nunchaku and BIKA tubes for Bicanalicular Silicone Intubation in Dacryocystorhinostomy
Author: Jaskaran Singh Bhangu
Base Hospital / Institution: Moorfields Eye Hospital / Swansea University
ePoster presentation
Abstract ID: 25-384
Purpose
To compare the efficacy and complications associated with FCI Nunchaku and FCI BIKA® silicone intubation tubes in patients undergoing external and endonasal dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction (NLDO) in adults.
Methods
A retrospective, comparative study was conducted at a tertiary ophthalmic unit, analysing 88 adult patients who underwent DCR surgery between January 2024 and March 2025. Follow up data was collected for 18 weeks after surgery. Of the 88 patients, 34 were intubated with FCI Nunchaku tubes (self-retaining) and 57 with FCI BIKA® tubes (tied) following DCR. The primary outcomes assessed were resolution of NLDO symptoms and intraoperative, early and late postoperative complications, including premature tube extrusion.
Results
The two groups were comparable in terms of age, gender, redo surgery and mix of external and endonasal approaches. There was no significant difference in NLDO symptom resolution between BIKA® and Nunchaku tubes at 6 weeks and 18 weeks. There were comparable rates of early complications between both types of tubes (10.5% vs 14.7%, p=0.77). However, there was noteworthy difference in type of early complications. Tube extrusion occurred only with Nunchaku (11.8% vs 0%, p=0.564). In the BIKA group, there was one that required tube removal in theatre. Late complications were lower with Nunchaku (2.9% vs 7.4%, p<0.001). More unscheduled reviews were needed for Nunchaku tubes (29.4% vs 22.2%, p<0.001).
Conclusion
This study demonstrates that both FCI Nunchaku and FCI BIKA® tubes are effective for bicanalicular intubation in DCR for NLDO, with no significant difference in NLDO symptom resolution. Nanchaku intubation technique offers a simpler and more convenient approach for tube removal and had no cases requiring retrieval in theatre making it a viable alternative to BIKA® tubes in clinical practice. Whilst there were some cases of premature tube extrusion with Nunchaku, this had no effect on efficacy of surgery.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Laura | Ah-Kye | Moorfields Eye Hospital |
| Ali | Istanaksai | Moorfields Eye Hospital |
| Munazzah | Chou | Moorfields Eye Hospital |
| Mumta | Kanda | Moorfields Eye Hospital |
| Emma | Samia Aly | Moorfields Eye Hospital |
| Swan | Kang | Moorfields Eye Hospital |
