Related Experiment Video
Updated: Aug 7, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Hydrostatic pressure as an office procedure for congenital nasolacrimal duct obstruction
Chaim Stolovitch1, Adi Michaeli
1Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. stolovic@netvision.net.il
Insights
Hydrostatic pressure effectively treats congenital nasolacrimal duct obstruction (CNDO) in infants. Success rates are highest in younger infants, but the procedure can be safely repeated at any age.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Surgical Innovation
Background:
- Congenital nasolacrimal duct obstruction (CNDO) affects 5% to 20% of infants.
- CNDO can cause persistent epiphora and discharge.
- Effective treatment options are crucial for infant well-being.
Purpose of the Study:
- To evaluate the success rate of hydrostatic pressure (Crigler method) for treating CNDO.
- To determine the efficacy of hydrostatic pressure as an outpatient procedure.
- To assess the impact of patient age on treatment success.
Main Methods:
- A total of 742 infants with CNDO were treated with hydrostatic pressure.
- The noninvasive procedure could be repeated up to three times.
- Success was defined as the absence of epiphora or discharge.
Main Results:
- The overall success rate for the study group was 45% in children up to one year of age.
- First-attempt success was 46%, with subsequent attempts yielding 35% and 38% success.
- Success rates were significantly higher in infants younger than two months (56%) compared to older infants.
Conclusions:
- Hydrostatic pressure is an effective treatment for infant CNDO, reducing associated morbidity.
- Early intervention (infants up to two months) yields the highest success rates.
- The procedure is safe, repeatable, and recommended for all infants with CNDO.
Background:
The estimated incidence of congenital nasolacrimal duct obstruction (CNDO) is 5% to 20%. We examined our success rate of treating CNDO with hydrostatic pressure (the Crigler method) as an office procedure.
Methods:
A total of 742 children with CNDO initially were treated noninvasively with hydrostatic pressure. The procedure was safely repeated up to 3 times, with an interval of at least 1 week, if the condition persisted.
Results:
Success was defined as no epiphora or discharge. The success rate for the entire study group was 45% for children up to 1 year of age. The ducts were opened in 46% (343/742) at the first attempt of hydrostatic pressure, in 35% (42/120) at the second attempt, and in 38% (8/21) at the third attempt. When the maneuver was performed in patients younger than 2 months of age, the success rate of the first attempt was 56%, decreasing to 46% in children 2 to 6 months of age and to 28% older than 6 months of age.
Conclusions:
Hydrostatic pressure is an effective way of resolving infant CNDO and shortening the duration of the associated morbidity. The success rate is higher when the procedure is conducted in patients up to 2 months of age. Nevertheless, we recommend this approach for every infant presenting with CNDO at the first office visit, even after 6 months of age. Procedures can be repeated safely and successfully.
Related Concept Videos
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:28Angle Closure Glaucoma: Treatment
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:25Glaucoma: Overview