Balloon Dacryoplasty and Monocanalicular Stenting Outcomes in Congenital Nasolacrimal Duct Obstruction

Abstract

Purpose : Congenital nasolacrimal duct obstruction (CNLDO) in children can be treated surgically with probing and irrigation, canalicular stenting, or balloon dacryoplasty. Success rates for both stenting and dacryoplasty have ranged from 73-90%. This study aims to determine the success rate of balloon dacryoplasty with concurrent monocanalicular stenting (BD+S) as a primary or secondary procedure in congenital nasolacrimal duct obstruction (CNLDO).

Methods : Single-center retrospective cohort study of all children with CNLDO who underwent BD+S from 2009-2019. Patients who had previous probing and stent placement or probing alone were also included. All BD+S procedures were performed at the Children’s Hospital of Philadelphia by one of three surgeons (JK, WK, KR). Primary outcome was failure rate, defined as recurrence of tearing symptoms after stent removal.

Results : 98 children (143 NLD) were included in the study; 16 patients (16%) with 22 nasolacrimal ducts (15%) were under the age of 2 years. Mean follow up was 3.3 months (range 3 days – 9.3 months). On follow up, 46/143 (32%) eyes were still symptomatic. Recurrent tearing was seen in 5/22 (23%) NLD below age 2 years and 41/121 (34%) above age 2 years. Chi square analysis did not show any significant difference between the two groups (p= 0.36). Failure rates were similar for primary (25/79, 32%) vs secondary (18/55, 33%) BD+S. Stenosis of the NLD was seen in 47% of the failures.

Conclusions : Balloon dacryoplasty with concurrent monocanalicular stenting either as a primary or secondary procedure had a success rate of 68% for reducing tearing in CNLDO, lower than previously reported rates of 73-87% for BD. Failures were frequently associated with NLD stenosis.

This is a 2021 ARVO Annual Meeting abstract.