Management of congenital nasolacrimal duct obstruction: results of a national survey of paediatric and oculoplastic ophthalmologists

Golash, Vidushi; Kaur, Harpreet; Athwal, Sarju; Chakartash, Rebiye; Laginaf, Masara; Khandwala, Mona

doi:10.1038/s41433-020-01183-5

Cited by 13 publications

(10 citation statements)

References 18 publications

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“…Congenital nasolacrimal duct obstructions are often caused by developmental defects of the structures of the nasolacrimal duct 11,12 . The most common type is membranous occlusion at the level of Hasner's valve [11][12][13] . The management of congenital nasolacrimal duct obstruction remains controversial because spontaneous resolution reportedly occurs in up to 90% of patients by the age of 12 months [13][14][15] .…”

Section: Discussionmentioning

confidence: 99%

“…The most common type is membranous occlusion at the level of Hasner's valve [11][12][13] . The management of congenital nasolacrimal duct obstruction remains controversial because spontaneous resolution reportedly occurs in up to 90% of patients by the age of 12 months [13][14][15] . Spontaneous resolution with conservative treatment in the second year of life has not been extensively reported [14][15][16][17] .…”

Section: Discussionmentioning

confidence: 99%

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Comparison of success rates of probing surgery in congenital nasolacrimal duct obstruction by age range

Ulas

Özcan

ADEMOĞLU

2023

Cukurova Medical Journal

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Purpose: To evaluate the effectiveness of probing surgery in patients with congenital nasolacrimal duct obstruction (CNLDO) according to application time and age groups. Materials and Methods: In this retrospective study, patients with CNLDO who were followed up at Cukurova University Faculty of Medicine between 2012 and 2022 were evaluated. One hundred thirteen eyes of 90 patients with CNLDO were included in the study. The fluorescein dye disappearance test was used to evaluate the diagnosis and treatment success. The demographic characteristics of the patients and the success of the surgeries were recorded. Results: Considering the first probing surgical time, our success rates according to age groups were as follows: 0-12 months (n=10) 100%, 12-18 months (n=29) 86.2%, 18-24 months (n=24) 87.5%, 24-36 months (n=24) 79.2%, 36-48 months (n=14) 57.1%, and 66.7% in patients aged 48 months and older (n=12). When our entire patient group was evaluated regarding success before and after age 2 years, the rate was 88.9% in patients younger than 24 months (n=63), and 70% in patients aged 24 months and older (n=50). Conclusion: In our study, the most successful age ranges for probing surgery were found as 0-12 months, 12-18 months, and 18-24 months. Probing surgery should be performed for patients with congenital nasolacrimal duct obstruction before the age of 2 years because the success rates decreased in patients older than 2 years in our study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of success rates of probing surgery in congenital nasolacrimal duct obstruction by age range

Ulas

Özcan

ADEMOĞLU

2023

Cukurova Medical Journal

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“…Although the early study about endoscopy-assisted probing concluded that endoscopy usage is not required in most cases [22], more recent studies reported positive results using endoscopy in CNLDO [23,24]. However, a recent survey from the United Kingdom showed that while 43.9% of oculoplastic consultants were using nasoendoscopy, only 12.9% of pediatric consultants were [25]. Considering that the primary treatment of a prevalent disease such as CNLDO is also applied by general ophthalmologists, it can be predicted that the overall rate of endoscopy use is lower than these rates.…”

Section: Discussionmentioning

confidence: 99%

Effect of age on primary balloon dacryocystoplasty and probing success in congenital nasolacrimal duct obstruction

et al. 2022

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Purpose: To compare the success rates of balloon dacryocystoplasty (BDP) and probing as a primary procedure in congenital nasolacrimal duct obstruction (CNLDO) and investigate the effect of age on both procedures.Methods: A total of 135 patients (171 eyes) with simple or incomplete complex CNLDO were included in this retrospective study; complete complex CNLDO cases were excluded. The success rates for primary BDP (118 eyes) and for probing (53 eyes) were compared as overall and among the age groups; Group 1 (12-24 months old), Group 2 (25-36 months old), and Group 3 (> 36 months old).Results: Mean age of the patients was 41.5±27.2 months for primary BDP, and 21.8±10.8 months for probing (p<0.001). Overall success rates for primary BDP and probing were 81.1% (43/53) and 76.3% (90/118), respectively (p=0.481). Success rates for BDP and probing among age groups were, 93.8% and 85.3% in Group 1 (p=0.306), 93.3% and 50.0% in Group 2 (p=0.012), and 63.6% and 27.3% in Group 3 (p=0.052), respectively. Cox regression analysis showed that the median ages were 18 months for probing and 36 months for primary BDP. Poisson regression model showed that, for every one-month increase in patients' age, the success rate of probing decreased by 9.7%. Conclusion:Probing success decreased to a point where different treatment options such as primary BDP can be discussed with the patient's parents after 18 months of age. The success of BDP decreased after 36 months, while it maintained a high success rate between 24-36 months as primary treatment.

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“…Various investigations are suggested to visualize the anatomy of congenital lacrimal fistula and the patency and function of lacrimal drainage system, such as fluorescence dye disappearance test (FDDT), lacrimal irrigation, dacryocystography and so on. FDDT is a noninvasive test for evaluating the excretory function with high specificity and positive prediction value [15][16] . However, in some cases of fistulas, the FDDT may not show patency of the lacrimal system, since fistulas with high outflow can drain all the contrast and the lacrimal system may stay out of the fluorescein.…”

Section: Dear Editormentioning

confidence: 99%

Congenital lacrimal fistulas with secondary infection mimicking acute dacryocystitis: a case report and literature review

Xu¹,

Shi²,

Ye³

et al. 2022

Int J Ophthalmol

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Management of congenital nasolacrimal duct obstruction: results of a national survey of paediatric and oculoplastic ophthalmologists

Cited by 13 publications

References 18 publications

Comparison of success rates of probing surgery in congenital nasolacrimal duct obstruction by age range

Comparison of success rates of probing surgery in congenital nasolacrimal duct obstruction by age range

Effect of age on primary balloon dacryocystoplasty and probing success in congenital nasolacrimal duct obstruction

Congenital lacrimal fistulas with secondary infection mimicking acute dacryocystitis: a case report and literature review

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