Balloon catheter dilatation versus probing as primary treatment for congenital dacryostenosis

Goldich, Yakov; Barkana, Yaniv; Zadok, David; Avni, Isaac; Pras, Eran; Mezer, Eedy; Morad, Yair

doi:10.1136/bjo.2010.183301

Cited by 13 publications

(6 citation statements)

References 25 publications

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“…Both procedures had a high success rate (86% for probing and 90% for balloon catheter dilatation), that were not diminished in children older than 36 months. Similarly, Goldich et al did not find a significant difference in the surgical outcomes of probing as compared to balloon catheter dilatation, except for patients who had a relatively narrow nasolacrimal bone duct [22]. In general, we agree with the approach that age is not a determinant factor in the decision whether to perform balloon dilatation and silicone intubation in the primary surgery for NLDO.…”

Section: Discussionsupporting

confidence: 80%

Outcomes of Congenital Nasolacrimal Duct Obstruction Surgery Converted into Balloon Dilation and Silicone Intubation due to Probing Difficulty

Sagiv

Nemet

Achiron

et al. 2022

Journal of Ophthalmology

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Background. To report the outcomes of balloon catheter dilatation and silicone intubation as a sequential secondary surgery under the same anesthesia, a stepwise approach for congenital nasolacrimal duct obstruction (NLDO) when probing and irrigation as primary procedure fails. Methods. A retrospective study included children with NLDO who underwent probing and irrigation only, and those who underwent in the same surgery under anesthesia, adjunct balloon catheter dilation and silicone intubation due to difficulty of the probe passage or fluid regurgitation from the punctum. The primary outcome was surgical success defined as resolution of preoperative symptoms and signs at 1 month. Results. A total of 105 NLDO cases were included. Eighty-four cases underwent probing and irrigation only, whereas 21 cases required balloon dilation and silicone intubation consecutively after the first procedure. Patient age at surgery was higher for those requiring balloon dilatation and intubation (30.3 ± 8.0 months) when compared to those with probing and irrigation only (22.4 ± 10.3 months, p < 0.001 ). The onset of symptoms, preoperative clinical findings regarding tearing and discharge and gender distribution of patients were comparable between the two groups. During the follow-up, the overall success rate for probing and irrigation only was 76.2% (64 out of 84 cases) and for balloon dilatation and silicone tube intubation was 90.5% (19 out of 21 cases). Conclusions. The surgical team may prepare to proceed with secondary surgery under the same anesthesia after the initial attempt of probing and irrigation. This stepwise two-stage approach in patients with congenital NLDO failing primary surgery resulted in a high success rate with minimal interventions, avoiding repeated general anesthesia.

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Section: Discussionsupporting

confidence: 80%

Outcomes of Congenital Nasolacrimal Duct Obstruction Surgery Converted into Balloon Dilation and Silicone Intubation due to Probing Difficulty

Sagiv

Nemet

Achiron

et al. 2022

Journal of Ophthalmology

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“…Another confounding factor in this study was that the mean age was 56 months in the balloon catheter group and 18 months in the probing group. 18…”

Section: Discussionmentioning

confidence: 99%

“…11,12 It was originally described as a secondary treatment after failed probing, but recent studies reported high success rates as both a primary and secondary procedure. 13–19…”

mentioning

confidence: 99%

Balloon catheter dilation as the primary treatment of congenital nasolacrimal duct obstruction

Gazit

Pras

et al. 2019

European Journal of Ophthalmology

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Purpose: The aim of this study is to report the outcome of balloon catheter dilation as the primary treatment of congenital nasolacrimal duct obstruction in children of all ages. Methods: A 10-year retrospective study of 148 children (270 eyes), aged 9 to 159 months (mean age: 29.6 ± 17.7 months), who previously had not undergone a nasolacrimal surgical procedure and who presented with clinical signs of nasolacrimal duct obstruction, was conducted. All children underwent balloon catheter dilation of the nasolacrimal duct. Results: Treatment success, defined as complete resolution of nasolacrimal duct obstruction symptoms present at follow-up visits at 1 week and up to 6 months after surgery, was 87% (234 of 270 eyes). Partial success was defined as occasional tearing which was acceptable to parents and present in 3% (nine eyes). Only 10% of the children underwent a second procedure due to complete failure. In a sub-analysis by age groups—under 18 months, between 18 and 36 months, and above 36 months—complete resolution rates were 85%, 93%, and 77%, and partial success rates were 3%, 3%, and 4%, respectively. There was a statistically significant difference between the age groups ( p = .007). Conclusion: In this large cohort of patients with nasolacrimal duct obstruction, balloon catheter dilation was successful as a primary treatment for congenital nasolacrimal duct obstruction, particularly under the age of 36 months.

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“…3 mm aufgepumpt werden kann. Der Behandlung werden Erfolgsraten von 77 bis 90 % zugeschrieben [33,34].…”

Section: Stufe 4 -Dakryoendoskopie Oder Ballonkatheterdakryoplastikunclassified

Stufenkonzept zur Therapie der konnatalen Dakryostenose

Heichel

2017

Klin Monatsbl Augenheilkd

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Unresolved epiphora in childhood is one of the most frequent issues in paediatric ophthalmology. In this context, connatal nasolacrimal duct obstruction (CNLDO) is the most important differential diagnosis and the condition is caused by a persistent Hasner's membrane in most cases. As there is a risk of complications, treatment should be considered. Therapeutic options include conservative and invasive approaches. As CNLDO is associated with high spontaneous recovery rates during the first years of life, the indication for invasive interventions must be carefully deliberated in that period. Conservative treatment with digital compression of the lacrimal sac should be performed whenever CNLDO is suspected. Invasive treatment is recommended in case of complications such as acute dacryocystitis or recurrent ascending infections. Furthermore, CNLDO seems to be amblyogenic. In addition to probing and syringing, temporary intubation of the lacrimal duct is possible. Further transcanalicular approaches include dacryoendoscopy or balloon dacryoplasty. Dacryocystorhinostomy should be reserved for special indications, although it has a low rate of complications and treatment is successful in 90 % of cases. The available treatment approaches can be integrated into a graduated treatment concept, which is influenced by many factors and should therefore be individualised.

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Balloon catheter dilatation versus probing as primary treatment for congenital dacryostenosis

Abstract: Children who had balloon catheter dilatation had a slightly better success rate than those who had probing; however, this difference was statistically significant only for patients who had a relatively narrow nasolacrimal bone duct.

Cited by 13 publications

References 25 publications

Outcomes of Congenital Nasolacrimal Duct Obstruction Surgery Converted into Balloon Dilation and Silicone Intubation due to Probing Difficulty

Outcomes of Congenital Nasolacrimal Duct Obstruction Surgery Converted into Balloon Dilation and Silicone Intubation due to Probing Difficulty

Balloon catheter dilation as the primary treatment of congenital nasolacrimal duct obstruction

Stufenkonzept zur Therapie der konnatalen Dakryostenose

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