Abstract
Purpose :
Congenital nasolacrimal duct obstruction (CNLDO) is a common cause of epiphora in infants. The purpose of this study was to determine the effectiveness of probing and syringing for treatment of CNLDO at the Royal Hospital for Children (RHC), Glasgow, United Kingdom over a 5 year period.
Methods :
A retrospective study was carried out within the paediatric ophthalmology department at the RHC, Glasgow, United Kingdom. A medical record search was conducted using the OPERA theatre management system. 144 patients who underwent nasolacrimal duct probing and syringing under general anaesthesia between 2012 and 2016 were identified. The diagnosis of nasolacrimal duct obstruction was based on the clinical history of epiphora with or without mucopurulent discharge and regurgitation following ocular examination.
Patient clinical notes were analyzed retrospectively, documenting the following parameters: age at time of procedure, laterality and post-operative success. Success was defined as complete absence of signs and symptoms post-operatively. Patients were followed up at 6 weeks post procedure.
Results :
The average age of the patient at the time of probing was 2.4 years. 47% of patients presented with bilateral obstruction. 29% of patients presented with left eye obstruction. 25% of patients presented with right eye obstruction.
The most common signs and symptoms of patients studied were epiphora, discharge or conjunctivitis. Epiphora was the most common presentation, found in 53% of patients. 24% of patients presented with discharge. A further 23% of patients presented with conjunctivitis. 81% of patients were found to be symptom free at the point of their first follow up with obstruction resolving successfully with probing and syringing. 8 patients (5.5%) had an endoscopic Dacryocystorhinostomy (DCR) under the Ear Nose and Throat (ENT) team. None of the patients had surgical or anaesthesia related complications.
Conclusions :
In summary, from a sample of 144 patients we can say that the majority of cases of nasolacrimal probing and syringing were successful in alleviating symptoms and signs of CNLDO in our paediatric cohort. Our results show that probing and syringing of the nasolacrimal duct under general anaesthesia is a safe and effective method of treating congenital nasolacrimal duct obstruction.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.