Effect of age on the success rate of lacrimal probing in the congenital nasolacrimal duct obstruction

doi:10.16352/j.issn.1001-6325.2024.05.0709

Abstract

Abstract: Objective To explore the effect of age factor on the success rate of lacrimal probing in the congenital nasolacrimal duct obstruction (CNLDO). Methods This report was based on a single-center retrospective case series study. The gradient therapeutic regimen was adopted, and lacrimal probing was undertaken to treat CNLDO when conservative treatment was ineffective. The patients were categorized into 4 groups by age: 0-＜6 months,6-＜12 months,12-＜24 months and 24-60 months. The success rate of probing in each group was compared and the correlation with age was analyzed. Results A total of 314 eyes of 269 patients were included. The success rates of primary probing in 4 groups were 86.8%, 91.7%, 73.6% and 37.8%, respectively. The overall success rate of probing in all patients was 84.7%(266/314). The decreased success rate of probing at age beyond 12 months was significantly correlated with increasing age(P＜0.001). No significant correlation was found with sex or laterality. Conclusions Staged treatment strategy is safe and effective. The success rate of probing is negatively correlated with age. Initial probing is recommended in children under 2 with failure of the conservative management.

Key words: congenital nasolacrimal duct obstruction, age, epiphora, probing, stenting

CLC Number:

R779.7

WU Xingzhi, SUN Hua, DING Jingwen. Effect of age on the success rate of lacrimal probing in the congenital nasolacrimal duct obstruction[J]. Basic & Clinical Medicine, 2024, 44(5): 709-713.

References

[1] MacEwen CJ, Young JD. Epiphora during the first year of life[J]. Eye (Lond), 1991,5:596-600.
[2] Mohney BG, Sathiamoorthi S, Frank RD. Spontaneous resolution rates in congenital nasolacrimal duct obstruction managed with massage or topical antibiotics compared to observation alone[J]. Br J Ophthalmol,2022,106:1196-1199.
[3] Ali MJ, Kamal S, Gupta A, et al. Simple vs complex congenital nasolacrimal duct obstructions: etiology, management and outcomes[J]. Int Forum Allergy Rhinol,2015,5:174-177.
[4] Farrokhi S, Schüttauf F, Spitzer MS, et al. Congenital nasolacrimal obstruction: a real-life study from the first symptoms to the results of surgical treatment[J]. Ophthalmologe,2021,118:1031-1037.
[5] Sun H, Ding J, Li D, et al. Comparison of Hasner valvulotomy outcomes in pediatric and adult patients: does age matter?[J]. Chin Med J (Engl),2020,133:2422-2428.
[6] Lin AE, Chang YC, Lin MY, et al. Comparison of treatment for congenital nasolacrimal duct obstruction: a systemic review and Meta-analysis[J]. Can J Ophthalmol,2016,51:34-40.
[7] Sathiamoorthi S, Frank RD, Mohney BG. Spontaneous resolution and timing of intervention in congenital nasolacrimal duct obstruction[J]. JAMA Ophthalmol,2018,136:1281-1286.
[8] Asano M, Takeuchi M, Ohno T, et al. Lacrimal sac massage for congenital nasolacrimal duct obstruction: a multicentre randomised controlled trial[J]. Br J Ophthalmol,2024: bjo-2023-324595. doi:10.1136/bjo-2023-324595. Online ahead of print.
[9] 中华医学会眼科学分会眼整形眼眶病学组. 中国先天性鼻泪管阻塞诊疗专家共识[J]. 中华眼科杂志,2021,57:814-818.
[10] 中国妇幼保健协会儿童眼保健专业委员会. 关于婴幼儿泪道相关疾病诊断及治疗的专家共识[J]. 中国斜视与小儿眼科眼科杂志,2021,29:1-4.
[11] Pediatric Eye Disease Investigator Group, Repka MX, Chandler DL, et al. Primary treatment of nasolacrimal duct obstruction with probing in children less than four years old[J]. Ophthalmology,2008,115:577-584.
[12] Hung CH, Chen YC, Lin SL, et al. Nasolacrimal duct probing under topical anesthesia for congenital nasolacri-mal duct obstruction in Taiwan[J]. Pediatr Neonatol,2015,56:402-407.
[13] Świerczyńska M, Tobiczyk E, Rodak P, et al. Success rate of probing for congenital nasolacrimal duct obstruction at various ages[J]. BMC Ophthalmol,2020,20:403. doi:10.1186/s12886-020-01658-9.
[14] Muthumalai M, Alam MS, Shrirao N, et al. A case-control study to determine the microbiological spectrum and antibiotic sensitivity patterns in congenital nasolacrimal duct obstruction[J]. J Curr Ophthalmol,2022,34:251-256.
[15] Kim D, Lew H. Comparison of outcomes of silicone tube intubation with or without dacryoendoscopy for the treatment of congenital nasolacrimal duct obstruction[J]. J Clin Med,2023,12:7370. doi:10.3390/jcm12237370.