Extrusion rates and postoperative emergency visits in tied and untied bicanalicular silicone stents in pediatric lacrimal surgery.

PURPOSE: The purpose is to compare rates of stent extrusion and emergency visits in tied and untied Crawford stents for pediatric lacrimal surgery. METHODS: This retrospective chart review included 166 eyes of 129 patients from 2018 to 2022. Data collected included tied/untied status, premature prolapse, retention, and time of removal, number of postoperative visits, emergent visits before scheduled follow-up, final follow-up, and surgical success. RESULTS: Of 166 eyes, 97 received tied stents and 69 received untied stents. Success rates, defined by need for additional surgery and symptoms, were similar between groups. However, untied stents prolapsed more often (P < 0.05) but led to fewer total follow-up visits (P < 0.05), including emergency, clinic, and telemedicine encounters. Of the 32 early visits in the tied group, 15 were emergency room visits; none of the 9 early visits in the untied group were. Patients with tied stents had significantly more postoperative visits (mean 1.9 vs. 1.1; P < 0.05). CONCLUSION: Untied Crawford stents for standard nasolacrimal duct intubation have similar success rates to tied Crawford stents. Untied stents had a significantly lower healthcare burden with fewer postoperative ER visits.