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April 1987

Prevention of Prolapsed Silicone Stents in Dacryocystorhinostomy Surgery

Author Affiliations

Salt Lake City

Arch Ophthalmol. 1987;105(4):455. doi:10.1001/archopht.1987.01060040025007

To the Editor.  —Silicone stents are commonly used in dacryocystorhinostomy (DCR) surgery to maintain a patent mucosal passageway into the nose. The use of these stents, however, is not without complications. Lateral displacement of the tube, punctal erosion, slitting of the canaliculus, and conjunctival or corneal irritation are a few of the many associated problems.1 Tube displacement and lateral migrations (prolapsed stents referred to as the spaghetti syndrome) occur frequently and at times can be difficult to correct. These usually occur as a result of the patient pulling on the exposed tubing that passes from punctum to punctum or catching it with a handkerchief when wiping the eye.Silicone stent prolapse following DCR surgery is usually treated by locating the tubing in the nose and pulling it back into the proper position with bayonet forceps following cocaine anesthesia. Despite careful inspection, however, the inferior end of the silicone tube