CNLDO: choose endoscopy-guidance and NOT a blind procedure

Ali, Mohammad Javed

doi:10.1080/01676830.2021.1959620

Cited by 9 publications

(2 citation statements)

References 7 publications

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“…1,2,6,7,25 Some authors suggest an endonasal endoscopic examination is necessary for all nasolacrimal procedures. 26 The primary surgeon in this series chose to avoid endoscope use when a stent was successfully placed. This allowed for optimal surgical time and less expense to the patient.…”

Section: Discussionmentioning

confidence: 99%

Primary Monocanalicular Stent Intubation for Children With Congenital Nasolacrimal Duct Obstruction: Surgical Outcome and Risk Factors

Katowitz

Prat

Munroe

et al. 2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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To determine the risk factors impacting the surgical success of primary monocanalicular stent intubation for congenital nasolacrimal duct obstruction (CNLDO).Methods: This is a retrospective interventional case series of patients 18 years and younger treated more than a 12-year period with monocanalicular stent intubation with inferior turbinate fracture for CNLDO by a single surgeon. Patients with dacryocystoceles, dacryocystitis, Down syndrome and previous tear duct surgery were excluded. An intraoperative grading scale of tear duct stenosis, date of stent removal, stent length, and postoperative symptoms were recorded. Surgical success was defined as the complete resolution of symptoms.Results: One thousand four hundred sixty-nine stents were placed in 1,001 pediatric participants (533 unilateral, 468 bilateral). The mean age at surgery was 1.86 years (0.1-18.07). The mean follow up was 34.99 months (0.43-134.3) with mean in-office stent removal at 3.41 months (0.63-36.9). Early stent loss occurred in 14.8% intubations (217/1,469). The overall success rate was 92.4% (1,357/1,469 eyes). Subjects less than the age of 4 years had a success rate of 92.8% (1,296/1,397) compared with 84.7% (61/72) in children more than 4. In multivariable analysis, bilateral surgery, severe tear duct stenosis, and early stent loss were significantly associated with higher risk of surgical failure.Conclusions: Severe tear duct stenosis, early stent loss, and bilateral surgery were significant risk factors for surgical failure. While the success rate stratified by age at surgery suggested a lower success after the age of 4. Primary monocanalicular stent intubation is an effective and safe treatment for CNLDO sparing a child the need for multiple staged surgeries.

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Section: Discussionmentioning

confidence: 99%

Primary Monocanalicular Stent Intubation for Children With Congenital Nasolacrimal Duct Obstruction: Surgical Outcome and Risk Factors

Katowitz

Prat

Munroe

et al. 2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…We agree with the authors that an endoscope is necessary to properly diagnose the cause of obstruction when necessary. Ali argues that an endoscope is imperative for all lacrimal surgeries, 2 but we believe it is not needed for most patients. 3 Furthermore, the use of an endoscope adds to the length of the surgery and the cost; while we regularly employ endoscopes, we do so only when diagnosing obstructions other than distal membranous or those caused by ductal stenosis, as were the cases in the current series.…”

Section: To the Editormentioning

confidence: 99%