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Paediatric dacryocystorhinostomy

K N Hakin1, T J Sullivan, A Sharma

  • 1Moorfields Eye Hospital, London, United Kingdom.

Australian and New Zealand Journal of Ophthalmology
|November 1, 1994
PubMed
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Dacryocystorhinostomy surgery in children is safe and effective for resolving congenital nasolacrimal duct obstruction. Success rates are highest when there is no associated canalicular disease.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery

Background:

  • Congenital nasolacrimal duct obstruction is a common condition in children.
  • Surgical intervention, such as dacryocystorhinostomy (DCR), is often necessary for persistent cases.
  • Canalicular involvement can complicate DCR outcomes.

Purpose of the Study:

  • To evaluate the safety and efficacy of dacryocystorhinostomy in pediatric patients.
  • To assess the impact of canalicular pathology on DCR success rates.
  • To determine the optimal surgical approach for different types of nasolacrimal duct obstruction.

Main Methods:

  • Retrospective review of 258 pediatric DCR cases from 1981-1991.
  • Categorization of cases based on obstruction type: simple congenital, punctal agenesis, lacrimal fistula, post-traumatic, and post-inflammatory.

Related Experiment Videos

  • Analysis of surgical outcomes with and without canalicular intubation or Lester-Jones tube placement.

    • Main Results:

    • 96% of children (171/177) without canalicular pathology were successfully treated with a single DCR operation.
    • DCR with canalicular intubation achieved substantial improvement in 79% of cases (55/70) with canalicular disease.
    • DCR with Lester-Jones tube showed improvement in 10 of 11 cases with canalicular disease.
    • No perioperative or postoperative blood transfusions were required.

    Conclusions:

    • Dacryocystorhinostomy is a safe and highly effective surgical procedure for pediatric nasolacrimal duct obstruction.
    • Outcomes are significantly better in the absence of canalicular pathology.
    • Experienced surgical technique is crucial for achieving optimal results in children.