Korean J Ophthalmol.  2010 Oct;24(5):261-266. 10.3341/kjo.2010.24.5.261.

Clinical Outcomes of Initial and Repeated Nasolacrimal Duct Office-Based Probing for Congenital Nasolacrimal Duct Obstruction

Affiliations
  • 1Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea. shbaek6534@korea.ac.kr
  • 2Kong Eye Medical Center, Seoul, Korea.

Abstract

PURPOSE
To characterize the outcomes of initial and repeated office-based probing as a primary treatment for congenital nasolacrimal duct obstruction (CNLDO) in children.
METHODS
The medical records of patients who underwent nasolacrimal duct office-based probing for CNLDO between March 2004 and January 2008 were reviewed retrospectively. Nasolacrimal duct probing was performed on 244 eyes from 229 consecutive patients with CNLDO. Patients who were refractory to the first probing underwent a second probing 4 to 8 weeks later.
RESULTS
Based on exclusion criteria, 244 eyes from 229 patients (117 males and 112 females), aged 6 to 71 months (mean, 12.4 +/- 8.36) were included. The success rate of the initial probing was 80% (196 of 244) for all patients, 82% (111 of 136) in the 6 to 12 month age group, 79% (64 of 81) in the 13 to 18 months age group, and 78% (21 of 27) among individuals older than 19 months (p = 0.868, Pearson chi-square test). The success rate of the second probing was 61% (25 of 41) for all patients, 74% (17 of 23) in the 6 to 12 months age group, 58% (7 of 12) in the 13 to 18 months age group, and 17% (1 of 6) among individuals older than 19 months (p = 0.043, Fisher's exact test).
CONCLUSIONS
While the success rate of initial nasolacrimal duct probing is not affected by age, the rate of success rate with a second probing was significantly lower in patients older than 19 months. Based on the results, authors recommend further surgical interventions, such as silicone tube intubation or balloon dacryocystoplasty, instead of repeated office probing for patients older than 19 months, if an initial office probing has failed.

Keyword

Congenital nasolacrimal duct obstruction; Nasolacrimal duct probing; Office probing; Repeated probing

MeSH Terms

Ambulatory Care
Child
Child, Preschool
Female
Humans
Infant
Korea
Lacrimal Duct Obstruction/congenital/*surgery
Male
Nasolacrimal Duct/*surgery
Retrospective Studies
Treatment Outcome

Reference

1. Guerry D 3rd, Kendig EL Jr. Congenital impatency of the nasolacrimal duct. Arch Ophthal. 1948. 39:193–204.
2. Noda S, Hayasaka S, Setogawa T. Congenital nasolacrimal duct obstruction in Japanese infants: its incidence and treatment with massage. J Pediatr Ophthalmol Strabismus. 1991. 28:20–22.
3. Paul TO, Shepherd R. Congenital nasolacrimal duct obstruction: natural history and the timing of optimal intervention. J Pediatr Ophthalmol Strabismus. 1994. 31:362–367.
4. Petersen RA, Robb RM. The natural course of congenital obstruction of the nasolacrimal duct. J Pediatr Ophthalmol Strabismus. 1978. 15:246–250.
5. Nelson LB, Calhoun JH, Menduke H. Medical management of congenital nasolacrimal duct obstruction. Pediatrics. 1985. 76:172–175.
6. Katowitz JA, Welsh MG. Timing of initial probing and irrigation in congenital nasolacrimal duct obstruction. Ophthalmology. 1987. 94:698–705.
7. Mannor GE, Rose GE, Frimpong-Ansah K, Ezra E. Factors affecting the success of nasolacrimal duct probing for congenital nasolacrimal duct obstruction. Am J Ophthalmol. 1999. 127:616–617.
8. Havins WE, Wilkins RB. A useful alternative to silicone intubation in congenital nasolacrimal duct obstructions. Ophthalmic Surg. 1983. 14:666–670.
9. Ogawa GS, Gonnering RS. Congenital nasolacrimal duct obstruction. J Pediatr. 1991. 119(1 Pt 1):12–17.
10. Kim YS, Moon SC, Yoo KW. Congenital nasolacrimal duct obstruction: irrigation or probing? Korean J Ophthalmol. 2000. 14:90–96.
11. Becker BB, Berry FD, Koller H. Balloon catheter dilatation for treatment of congenital nasolacrimal duct obstruction. Am J Ophthalmol. 1996. 121:304–309.
12. Repka MX, Chandler DL, Holmes JM, et al. Balloon catheter dilation and nasolacrimal duct intubation for treatment of nasolacrimal duct obstruction after failed probing. Arch Ophthalmol. 2009. 127:633–639.
13. Honavar SG, Prakash VE, Rao GN. Outcome of probing for congenital nasolacrimal duct obstruction in older children. Am J Ophthalmol. 2000. 130:42–48.
14. Gunton KB, Chung CW, Schnall BM, et al. Comparison of balloon dacryocystoplasty to probing as the primary treatment of congenital nasolacrimal duct obstruction. J AAPOS. 2001. 5:139–142.
15. Robb RM. Success rates of nasolacrimal duct probing at time intervals after 1 year of age. Ophthalmology. 1998. 105:1307–1309.
16. Kushner BJ. The management of nasolacrimal duct obstruction in children between 18 months and 4 years old. J AAPOS. 1998. 2:57–60.
17. el-Mansoury J, Calhoun JH, Nelson LB, Harley RD. Results of late probing for congenital nasolacrimal duct obstruction. Ophthalmology. 1986. 93:1052–1054.
18. Stager D, Baker JD, Frey T, et al. Office probing of congenital nasolacrimal duct obstruction. Ophthalmic Surg. 1992. 23:482–484.
19. Ffooks OO. Dacryocystitis in infancy. Br J Ophthalmol. 1962. 46:422–434.
20. Moon JS, Choi WC. Office probing of congenital nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 1999. 40:2357–2361.
21. Older J. Congenital lacrimal disorders and management. 1988. London: Churchill Livingstone.
22. Kashkouli MB, Kassaee A, Tabatabaee Z. Initial nasolacrimal duct probing in children under age 5: cure rate and factors affecting success. J AAPOS. 2002. 6:360–363.
23. Ahn DH, Lew H, Kim HY, Lee SY. The effect of probing for congenital nasolacrimal duct obstruction. J Korean Ophthalmol Soc. 1998. 39:836–840.
24. Ghuman T, Gonzales C, Mazow ML. Treatment of congenital nasolacrimal duct obstruction. Am Orthopt J. 1999. 49:163–168.
25. Welham RA, Bergin DJ. Congenital lacrimal fistulas. Arch Ophthalmol. 1985. 103:545–548.
26. Repka MX, Chandler DL, Beck RW, et al. Primary treatment of nasolacrimal duct obstruction with probing in children younger than 4 years. Ophthalmology. 2008. 115:577–584.
27. Baker JD. Treatment of congenital nasolacrimal system obstruction. J Pediatr Ophthalmol Strabismus. 1985. 22:34–36.
28. Steindler P, Mantovani E, Incorvaia C, Parmeggiani F. Efficacy of probing for children with congenital nasolacrimal duct obstruction: a retrospective study using fluorescein dye disappearance test and lacrimal sac echography. Graefes Arch Clin Exp Ophthalmol. 2009. 247:837–846.
29. Limbu B, Akin M, Saiju R. Age-based comparison of successful probing in Nepalese children with nasolacrimal duct obstruction. Orbit. 2010. 29:16–20.
30. Choi WC, Kim KS, Park TK, Chung CS. Intranasal endoscopic diagnosis and treatment in congenital nasolacrimal duct obstruction. Ophthalmic Surg Lasers. 2002. 33:288–292.
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