To the Editor.
—We read with interest the correspondence by Jordan and Anderson1 describing the technique for prevention of prolapse of silicone stents following dacryocystorhinostomy surgery. As this is a fairly common and inconvenient occurrence in the postoperative period, we immediately adopted their technique to secure the stents at the time of dacryocystorhinostomy. As Jordan and Anderson recommended, we used a 4-0 silk suture to secure the two arms of the silicone loop to each other with a square knot placed below the internal common punctum.In the first 17 patients in whom this additional step was taken, there were no prolapsed tubes. Interestingly, however, three patients developed the unusual complaint of a foul odor noted respectively at 3, 5, and 8 weeks postoperatively. One patient described the odor as smelling "like a dirty diaper in my nose." We had never previously heard this complaint among several hundred patients
Kersten RC, KULWIN DR. Suturing of Stents After Dacryocystorhinostomy. Arch Ophthalmol. 1988;106(9):1165-1166. doi:10.1001/archopht.1988.01060140325012