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Ma Khin Pyi Son, David Hodge, Brian Mohney; Timing of Congenital Nasolacrimal Duct Obstruction Resolution and the Development of Anisometropia. Invest. Ophthalmol. Vis. Sci. 2012;53(14):638.
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© ARVO (1962-2015); The Authors (2016-present)
Anisometropia was recently shown to develop in ten percent of infants diagnosed with nasolacrimal duct obstruction at a mean age of one year. The purpose of this study is to determine whether earlier (< 1 year) spontaneous resolution or probing decreases or eliminates this risk.
The medical records of all patients diagnosed as an infant with CNLDO from January 1, 1988, through December 31, 1992, and who later underwent a refraction were retrospectively reviewed. Anisometropia was defined as ≥ 1 diopter of refractive error between the two eyes.
A total of 560 infants were diagnosed with CNLDO during the 5-year period, of which 258 (46.1%) subsequently underwent a complete ophthalmic examination. Of the 258, 195 (75.6 %) spontaneously resolved at a mean age of 4.5 months (range, 0.3-35 months), 61 (23.6 %) were managed with probing at a mean age of 19.7 months (range, 0.5-100 months), and the remaining 2 had persistent tearing without treatment. Anisometropia developed in 21 (10.8 %) of the 195 who spontaneously resolved and in 4 (6.6 %) of the 61 operated children (p=0.33). Among those who underwent surgery, there was no significant difference (p=0.70) in the rate of anisometropia between those treated at less than (n=25), compared to greater than, one year of age (n=36).
Early spontaneous resolution of CNLDO is not associated with a lower subsequent risk of developing anisometropia. It is unclear, however, due to small numbers, whether or not early probing can modify or eliminate this risk.
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