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Published on: October 13, 2017
Initial nasolacrimal duct probing in children under age 5: cure rate and factors affecting success
Mohsen Bahmani Kashkouli1, Abolfazl Kassaee, Ziaeddin Tabatabaee
1Lacrimal and Adnexal Unit, Eye Department, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. babmanik@yahoo.com
Insights
Initial probing for congenital nasolacrimal duct obstruction (CNLDO) is highly successful in children under 5. Factors like age and canalicular stenosis affect success rates, with earlier intervention yielding better outcomes.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Congenital nasolacrimal duct obstruction (CNLDO) is a common condition in infants.
- Timely intervention is crucial for managing CNLDO and preventing complications.
Purpose of the Study:
- To determine the success rate of initial nasolacrimal duct probing for CNLDO in children under 5.
- To identify factors influencing the success of this procedure.
Main Methods:
- A prospective study included 139 patients (180 eyes) with CNLDO undergoing nasolacrimal duct probing.
- Success was defined as complete resolution of tearing and discharge.
- Patients were followed for 3 months post-procedure.
Main Results:
- The overall success rate for initial probing was high, particularly in younger children.
- Cure rates decreased with increasing age, with significant differences noted by the second year.
- Patient age, non-membranous CNLDO, and canalicular stenosis were associated with lower success rates.
Conclusions:
- Initial nasolacrimal duct probing is a safe and effective treatment for CNLDO in children up to 5 years.
- Early probing is recommended due to decreasing success rates with increasing age.
- Non-membranous CNLDO and canalicular stenosis are risk factors for treatment failure.
Aims:
To evaluate the success rate of initial probing and the factors affecting the success rate for congenital nasolacrimal duct obstruction (CNLDO)in children under the age of 5 years.
Methods:
In a prospective uncontrolled interventional case series, 207 eyes from 161 consecutive patients with CNLDO underwent nasolacrimal duct probing under brief general anesthesia. Based on exclusion criteria, 180 eyes from 139 patients were included in the study. Diagnoses were made according to the patients' histories, clinical examinations, and modified dye disappearance tests. The state of the punctum, the canaliculus, the sac, and the nasolacrimal duct were recorded. The main outcome measure was the complete disappearance of tearing and discharge in the affected eye. The patients were followed at 1 week, 1 month, and 3 months postoperatively.
Results:
The age range was 5 to 60 months (mean, 19.1 +/- 11.2 months). The cure rates were 92% in the first year, 84.5% in the second year, 65% in the third year, and 63.5 in the fourth and fifth years of age. The patient's age, nonmemberanous CNLDO, and canalicular stenosis were correlated with the success of initial nasolacrimal duct probing (P <.05).
Conclusions:
Based on the results, simplicity of probing, and absence of significant complications, initial nasolacrimal duct probing is advised up to the age of 5 years. Increasing age, nonmembranous CNLDO, and canalicular stenosis increase the failure rate (P <.05).
