Initial Late Probing For Congenital Nasolacrimal Duct Obstruction, Rate Of Success And Factors Associated With Failure.

Abstract

AIM: Evaluation of the efficacy of initial late probing for congenital nasolacrimal duct obstruction and identifying the risk factors associated with failure.

MATERIALS AND METHODS: A prospective interventional case series included 25 patients with congenital nasolacrimal duct obstruction (CNLDO) aged 2 years or older, with no previous intervention. The diagnosis was based on clinical findings (epiphora, discharge, regurge test and FDDT). Probing of the nasolacrimal duct under general anesthesia was done. The presence of firm or hard resistance during probing of the nasolacrimal duct was recorded as a complex obstruction; otherwise the obstruction was recorded as simple one. Success was predefined as resolution of symptoms and signs that persisted 3 months postoperative. Another probing was done when necessary before considering the final outcome as failure.

RESULTS: The age of patients ranged from 2-6 years (average age 2.96±0.81 years). Seven patients (28%) needed a second probing. The presence of chronic dacryocystitis was significantly associated with higher incidence of need for 2nd probing (66.7% P = 0.001*). The overall success rate was 84% (21 patients). The success of procedure was significantly lower in patients with complex obstruction (33.3% P = 0.011*). The outcome of probing was not affected by the age of the patients (P = 0.381).

CONCLUSION: Initial late probing is a good option for older children with CNLDO. The presence of chronic dacryocystitis is associated with higher incidence of need for 2nd probing, while the complex obstruction is a risk factor associated with significantly lower success rate.