Abstract
Purpose: :
To evaluate success rates of probing and irrigation performed for congenital nasolacrimal duct obstruction (NLDO) and approximate the age at which there is a significant increase in risk of procedure failure.
Methods: :
Records for probing procedures from 2002 to 2010 were reviewed. Successful probing was defined as complete resolution of epiphora after treatment. Success rates were compared among 3 groups: children aged less than 24 months (group 1), children 24 months and older but less than 60 months (group 2), and children 60 months and older but less than 11 years of age (group 3). For children with failed probing, results of Crawford tubing were also analyzed.
Results: :
170 eyes (130 children, mean age 31.7+/- 1.8 months) had undergone a probing procedure, and the overall success rate was 71.2% (121/170). The mean age of children in group 1 (100 eyes) was 18.3+/- 0.3 months, group 2 (49 eyes) was 39.8+/- 1.8 months and group 3 (21 eyes) was 96.3+/-4.8 months. Group 1’s success rate, 76% (76/100 eyes), was not significantly different from that of group 2 (73.5%) based on Fisher’s exact test (p=0.84). Group 3’s success rate was 42.9%. A multivariate analysis with group 1 serving as the reference group demonstrated that age was a significant risk factor for a failed probing (p=0.015). Group 2 was not at increased risk of failure (p=0.83, OR=1.09, 95%CI=0.49-2.46), while group 3 did have an increased risk of failure (p=0.004, OR=4.35, 95%CI=1.59-11.9). Crawford tubing had an overall success rate of 93.8% and showed no difference if performed prior to, or after age 60 months, based on Fisher’s exact test (p=0.13; OR=0.13, 95%CI=0.01-1.54).
Conclusions: :
Contrary to reports that probing is most successful before 24 months of age, this study shows that the success rate of probing is not significantly reduced when performed between the ages 24 and 60 months. The risk of failure increases after age 60 months. Tubing procedures are a successful second line therapy after a failed probing, regardless of age.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications