Blocked Tear Ducts: Intubation

Topic Overview

Blocked tear ducts are sometimes cleared using a procedure called intubation. During intubation, two small wire probes attached to silicone tubes are passed into the upper and lower tear duct openings (puncta) and down the tear duct drainage system into the nasal cavity. The wires are removed and the tubes are tied or sewn in place to keep the tear ducts open. Intubation is usually done as part of a probing procedure in the hospital using general anesthesia. Most people go home the same day.

From 3 to 16 weeks after surgery, the person returns to the doctor's office, and the tubes are removed. Anesthesia is usually not needed when the tubes are taken out.

Some doctors leave the tubes in place for 6 months to a year. This causes a new lining to form around the tubes, leaving an open channel in the tear duct when the tubes are removed.

Intubation leaves no facial scars. And it has less risk of complications than dacryocystorhinostomy, a procedure that creates a new tear duct canal. Intubation is sometimes used when a person:

• Has a partial blockage of a tear duct.
• Has had one or more failed probing attempts and who still has symptoms of a blocked tear duct.
• Wants to avoid the surgical incision (on the face) that results from dacryocystorhinostomy.
• Has had dacryocystorhinostomy surgery, and the tear duct has become blocked again.

Risks of intubation include the following:

• The tube may loosen and move out of place.
• The hole in the corner of the eyelid through which tears drain (punctum) may be damaged.
• The lining of the eyelids (conjunctiva) may become irritated.
• The person may feel discomfort inside his or her nose.

It is common to have a watery eye after surgery. Tears cannot drain as well through the affected tear duct while the very small tubes from the intubation are still in place.