Retrospective Evaluation of Surgical Methods and Outcomes of Pediatric Nasolacrimal Duct Obstruction According to Age Groups

Abstract

Aim: To evaluate the outcomes of different surgical methods in nasolacrimal duct obstruction (NLDO) in pediatric patients according to age groups. Material and Method: Patients with NLDO were included in the study. Records of patients who underwent nasolacrimal duct (NLD) probing, silicone tube intubation or endoscopic dacryocystorhinostomy (DCR) for congenital nasolacrimal duct obstruction (CNLDO) or acquired NLDO between 2015 and 2018 were retrospectively reviewed. The age of the patients during the surgery, the status of postoperative watering complaints and the presence of epiphora were analyzed according to age groups. Results: Of 150 patients, 77/150 (51.3%) were female, 73/150 (48.7%) were male. The mean age of patients was 22.3 (1 month-8 years) months. In this study, 174 eyes of 150 patients with NLDO were included. Patients were divided into four groups in terms of age groups at the time of admittance. A hundred percent of the first group (0-12 months) was treated successfully with the NLD probing. However, in the second group (12-24 months), the success rate was 81.8% with the NLD probing. In the third group (24-48 months), the success rate of NLD probing decreased to 52.4%, while the success rate of silicone tube intubation was 100% in the same age group. In the fourth group (48 months or over), the success rate of NLD probing decreased to 20%, while all procedures performed with endoscopic DCR and silicone tube intubation were successful. Conclusion: Pediatric patients with NLDO, the choice of the treatment procedure and the success rate of treatment vary according to age group. NLD probing procedure is a safe and effective treatment method for CNLDO in cases that are unresponsive to conservative treatment in the first 12 months of life. As the patients' age increases, the success of the NLD probing decreases. However, prior to an invasive treatment modality, NLD probing procedure is recommended more than one time.