A canalicular stenosis was identified in 29 of 66 (44%) children and 35 of 80 (44%) lacrimal drainage systems undergoing silicone intubation for congenital nasolacrimal duct obstruction, having previously had unsuccessful probings. The stenoses were equally divided between boys and girls and between right and left sides. There was no significant difference in age at the time of probing, number of prior probings, or age at intubation between children with and without canalicular stenosis. Stenoses may be congenital or acquired as a result of faulty probing. Any child undergoing a second lacrimal procedure after a failed probing should be evaluated for evidence of a canalicular stenosis. If a stenosis is present, a silicone stent should be placed to try to salvage the canaliculus.
"When bleeding is observed during a probing, it usually indicates false passage formation (Young and MacEwen 1997). When there is a probing failure, iatrogenic canalicular obstructions occur in 44% of patients (Lyon et al 1991). To prevent such iatrogenic obstructions, a " wait and see " policy with conservative management appears the best option. "
[Show abstract][Hide abstract] ABSTRACT: This study aimed to examine the rate of symptomatic improvement of congenital nasolacrimal duct obstruction (CNLDO) in Japanese infants treated with conservative management within the 1st year of age. Thirty-five lacrimal ducts in 27 patients diagnosed with CNLDO were included in the study. During the observational period, lacrimal ducts were massaged. As well, antibiotic eye drops, to be administered 4 times a day, were sometimes prescribed for obvious conjunctivitis. Two lacrimal ducts in 2 patients were probed before the 1st year of age because of dacryocystitis or severe blepharitis; these patients were included in the unimproved group. Twenty-nine lacrimal ducts in 21 patients resolved during the period (82.9%); with 16 lacrimal ducts resolving before six months of age. Therefore, a comparatively high percentage of resolution for CNLDO (82.9%) following conservative management was shown before the 1st year of age in Japanese infants.
[Show abstract][Hide abstract] ABSTRACT: Orthograde and retrograde endoscopy of the upper and lower nasolacrimal system was performed using two prototype ultrathin (0.5 mm and 1.1 mm diameter) fibrescopes on four cadaver heads. Appearances were verified by subsequent dissection. The procedure, which we term 'dacryocystoscopy' is described. With modifications this technique may have clinical applications in the treatment of nasolacrimal disorders.
British Journal of Ophthalmology 12/1992; 76(11):663-7. DOI:10.1136/bjo.76.11.663 · 2.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We studied spontaneous resolution of congenital nasolacrimal duct obstruction in the second year of life and compared this with the cure rate after probings undertaken between the ages of 11 and 15 months. Of the 111 eyes of 95 patients studied, 26 eyes were included in a randomised prospective comparison of probing with spontaneous resolution. A further 63 eyes followed a similar management plan to the randomised group and are reported as an observational study. Thirty of the 50 eyes followed up without treatment resolved spontaneously before the age of 2 years, of which 24 resolved before 18 months. The overall cure rate for probing was 74% compared with 60% for spontaneous resolution. At 15 months of age the randomised study confirmed that probing at 12-14 months is an effective intervention compared with spontaneous resolution (p = 0.04). At 24 months of age probing was superior in both randomised and non-randomised studies, but with increased numbers in the spontaneous resolution groups the difference was no longer statistically significant. Up to 18 months of age the frequency of spontaneous resolution makes delay in probing a viable management option to be discussed with the parents. It will also lead to an overestimate of the cure rate in any study of interventional treatment unless controls are included.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.