Comparative study of diathermy assisted probing and intubation versus standard probing and intubation in congenital nasolacrimal duct obstruction

Abstract

Purpose To compare the efficacy of diathermy-assisted probing and intubation to standard probing and intubation in children more than 2 years. Methods A prospective comparative randomized clinical study conducted from April 2019 to April 2020. Follow-up visits at 1 week, 1, 3, and 6-month. This study included 160 eyes of 104 children with congenital nasolacrimal duct obstruction. Children were divided into two groups; group I included 80 eyes of 50 children who underwent probing with a metal probe followed by intubation, and group II included 80 eyes of 54 children who underwent probing, diathermy, followed by intubation to assess the efficiency and success rate of endodiathermy probe followed by intubation in children. Results After 1 week and 1 month, both techniques were comparable as regards the MUNK score (P value = 0.11 for each). However, after 3 and 6 months, there was a statistically significant difference between both groups regarding the MUNK score (P-value=0.01 for each). Fluorescein disappearance test (FDT) results with a success rate were higher in group II than in group I (90% vs. 77.5%, P value = 0.03*). We removed 5 tubes early in group I and 3 tubes early in group II due to early tube extrusion or chess wiring. Conclusions The newly introduced diathermy-assisted probing and intubation could be considered as an alternative method to treat congenital nasolacrimal duct obstruction. The success rate is higher when compared with the standard method of intubation.