Journal of American Association for Pediatric Ophthalmology and Strabismus
Major articleInitial nasolacrimal duct probing in children under age 5: Cure rate and factors affecting success*
Section snippets
Subjects and methods
A survey of patients below the age of 5 years with CNLDO was conducted. A questionnaire was prepared to obtain the following data: age, sex, eye complaints (tearing, mucopurulent discharge, swelling or infection of the sac, aberrant opening of the lacrimal draining system onto the skin), mother's age at pregnancy, type of delivery (natural, cesarean), history of prior conservative treatment (massage and topical antibiotics), history of repeated conjunctivitis, and lid malposition. The exclusion
Results
In a prospective uncontrolled interventional case series, 207 eyes of 161 patients were evaluated. Twenty-seven eyes were excluded based on the exclusion criteria; 180 eyes from 139 patients were studied. Sixty-nine patients (49.6%) were boys. The ages of the patients at the probing were 5 to 60 months (mean ± SD, 19.18 ± 11.28) (Table 1).The mothers' ages at pregnancy varied between 16 and 38 years (mean, 24 ± 5.06 years). The type of delivery in 57 (41%) patients was cesarean section. The
Discussion
The incidence of symptomatic CNLDO is 3% to 6%.1 However, postmortem examinations of term and premature infants within the first month of birth suggested that the incidence of obstruction is 52% (unilateral or bilateral).3 There are 8 different types of CNLDO.3, 4 The most common, membranous obstruction, has the best response to treatment.4 The treatment of CNLDO can be either conservative or surgical.5 More than 90% of the eyes of patients with CNLDO resolve within the first 12 months of life.6
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Cited by (72)
Systematic review of endoscopic-assisted surgical management for congenital nasolacrimal duct obstruction
2020, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :Our study found that out of the cohort/case-control studies, there was a 75.3% success rate using conventional probing and a 95.3% success rate when a nasal endoscopic approach was used. Reported success rates using conventional probing are highly variable and dependent on the timing of the probing with ranges from 33.3% to 98.2% [3]. Many of these studies saw the highest success rates within the first year of age [3].
Sondage du canal lacrymo-nasal au cabinet chez les enfants de moins de 12 mois: Taux de guérison et évaluation des coûts
2016, Journal Francais d'OphtalmologieCitation Excerpt :The overall success rate for cure by immediate office probing was 76.7% in our study. However, many factors are believed to affect the success rate of nasolacrimal probing [9,13,24,25] Bilateral involvement may be a marker of more significant anatomical or physiological variations in the nasolacrimal duct, mucous membrane physiology, or the tear pump mechanism, which may be more difficult to cure with probing. However we did not find that bilaterality had a significant impact on the success rate of immediate probing.
Incision of Hasner's valve under endoscopic intranasal surgery for the treatment of nasolacrimal duct obstruction in children
2020, Journal of Laryngology and OtologyTreatment management of congenital nasolacrimal duct atresia: A review article
2023, Indian Journal of Clinical and Experimental Ophthalmology
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Reprint requests: Mohsen Bahmani Kashkouli, MD, Eye Department, Norfolk and Norwich University Hospital, Norwich NR4 7UZ, United Kingdom; e-mail, [email protected].