DOI: 10.1097/IOP.0000000000000093
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PMID: 24398507
Issn Print: 0740-9303
Publication Date: 2014/01/01
Management of Extruding Bicanalicular Nasolacrimal Stents: Primum Non Nocere
Julian D. Perry; Bryan R. Costin
Excerpt
We read with interest the letter by Fayet et al.1 providing management options for extruding bicanalicular nasolacrimal stents and would like to offer another simple maneuver to treat this condition: a pressure patch. We have found that placing a pressure patch over the eye and extruded stent often allows for spontaneous repositioning within 1 day. Even when unsuccessful, a patch serves as a temporizing measure to improve patient comfort and anxiety if presentation occurs when the surgeon is unavailable. Two other strategies we have found useful: sweeping a suction instrument behind, then under, the inferior turbinate during endoscopy; and finally, tying the tubes under a 4-0 vicryl collaret rather than into a knot allows for safer removal from the eyelid when repositioning maneuvers fail.
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