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Japanese Journal of Ophthalmology

, Volume 58, Issue 1, pp 94–99 | Cite as

Long-term results of probing guided with soft cannula in children with congenital nasolacrimal duct obstruction

  • Dilek YukselEmail author
  • Pınar Altiaylik Ozer
Clinical Investigation

Abstract

Purpose

To report the results of soft probing in children with congenital nasolacrimal duct obstruction (CNLDO).

Materials and Methods

A prospective, non-randomised interventional study included 158 eyes of 122 children aged 2 months–5 years, with CNLDO. A plastic intravenous catheter sheath supported intraluminally with a guiding metal probe was introduced through the superior canaliculus. During intubation, the plastic cannula was gently introduced through the nasolacrimal system, while the metal probe inside was withdrawn concurrently. After the complete withdrawal of the metal probe, the duct was irrigated with a high pressure saline solution through the plastic cannula. Once the obstruction was totally dissolved and a patent passage was observed, the plastic cannula was withdrawn and the procedure was completed with a nasolacrimal lavage with a gentamycin and dexamethasone combination.

Results

Clinically successful results were achieved in 142 eyes (89.8 %). No significant complications occured intraoperatively or postoperatively.

Conclusions

In children under age 5, our technique has a high success rate with no significant complications. This method allows probing in a more controlled way. This method may be particularly suitable for surgeons during training, when the most false lumen formation is observed.

Keywords

Congenital nasolacrimal duct obstruction Lacrimal lavage Probing 

Notes

Acknowledgments

A part of this study was presented as a poster at the 9th Congress of the International Society of Dacryology and Dry Eye (16–18 May 2008) in İstanbul.

Conflicts of interest

D. Yuksel, None; P. Altiaylik Ozer, None.

Supplementary material

Supplementary material 1 (WMV 14,913 kb)

References

  1. 1.
    MacEwen CJ, Young JDH. Epiphora in the first year of life. Eye. 1991;5:596–600.PubMedCrossRefGoogle Scholar
  2. 2.
    Young JDH, MacEwen CJ, Ogston SA. Congenital nasolacrimal duct obstruction in the second year of life: a multicenter trial of management. Eye. 1996;10:485–91.PubMedCrossRefGoogle Scholar
  3. 3.
    Olitsky SE, Nelson LB. Disorders of the eye. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics, 16th ed. Philedelphia, W.B. Saunders; 2000. p. 1911.Google Scholar
  4. 4.
    Paul TO. Medical management of congenital nasolacrimal duct obstruction. J Pediatr Ophtalmol Strabismus. 1985;22:68–70.Google Scholar
  5. 5.
    Piest KL. Katowitz JA. Treatment of congenital nasolacrimal duct obstruction. Ophthalmol Clin North Am. 1991;201–9.Google Scholar
  6. 6.
    Yuksel D, Ceylan K, Erden O, Kilic R, Duman S. Balloon dilatation for treatment of congenital nasolacrimal duct obstruction. Eur J Ophthalmol. 2005;179–85.Google Scholar
  7. 7.
    Ceylan K, Yuksel D, Duman S, Samim E. Comparison of two endoscopically assisted procedures in primary surgical treatment of congenital nasolacrimal duct obstruction in children older than 3 years: balloon dilatation and bicanalicular silicone tube intubation. Int J Ped Otorhinolaryngol. 2007;71:11–7.CrossRefGoogle Scholar
  8. 8.
    Hanovar SG, Prakash VE, Rao GN. Outcome of probing for congenital nasolacrimal duct obstruction in older children, Am J Ophthalmol. 2000;42–8.Google Scholar
  9. 9.
    Sevel D. Development and congenital abnormalities of the nasolacrimal apparatus. J Pediatr Ophthalmol Strabismus. 1981;13–9.Google Scholar
  10. 10.
    Baker JD. Treatment of congenital nasolacrimal system obstruction. J Pediatr Ophthalmol Strabismus. 1985;34–5.Google Scholar
  11. 11.
    Nelson LB, Calhoun LH, Menduke H. Medical management of congenital nasolacrimal duct obstruction. Ophthalmology. 1985;1187–90.Google Scholar
  12. 12.
    Paul TO, Shepherd R. Congenital nasolacrimal duct obstruction: natural history and the timing of optimal intervention. J Pediatr Ophthalmol Strabismus. 1994;362–67.Google Scholar
  13. 13.
    Manner GE, Rose GE, Frimpong-Ansah K, Ezra E. Factors affecting the success of nasolacrimal duct probing for congenital nasolacrimal duct obstruction. Am J Ophthalmol. 1999;616–7.Google Scholar
  14. 14.
    Casady DR, Meyer DR, Simon JW, Stasior GO, Zobal-Ratner JL. Stepwise treatment paradigm for congenital nasolacrimal duct obstruction. Ophthal Plast Reconstr Surg. 2006;22:243–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Maini R, MacEwen CJ, Young, JDH. Natural history of epiphora in childhood. Eye. 1998;669–71.Google Scholar
  16. 16.
    Bruce BB, Berry FD, Koller H. Balloon catheter dilatation for treatment of congenital nasolacrimal duct obstruction. Am J Ophthalmol. 1996;121:304–9.Google Scholar
  17. 17.
    Katowitz JA, Welsh MG. Timing of initial probing and irrigation in congenital nasolacrimal duct obstruction. Ophthalmology. 1987;94:698–705.PubMedCrossRefGoogle Scholar
  18. 18.
    Havins HE, Wilkins RB. A useful alternative to silicone intubation in congenital nasolacrimal duct obstructions. Ophthalmic Surg. 1983;14:660–70.Google Scholar
  19. 19.
    Stager O, Baker JD, Frey T, Weakly DR Jr, Bich EE. Office probing of congenital nasolacrimal duct obstruction. Ophthalmic Surg. 1992;23:482–4.Google Scholar
  20. 20.
    Sturrock SM, MacEwen CJ, Young JDH. Long-term results after probing for congenital nasolacrimal duct obstruction. Br J Ophthalmol. 1994;78:892–4.PubMedCrossRefGoogle Scholar
  21. 21.
    Pediatric Eye Disease Investigator Group. Primary treatment of nasolacrimal duct obstruction with probing in children less than 4 years old. Ophthalmology. 2008;115:577–84.PubMedCentralCrossRefGoogle Scholar
  22. 22.
    Zilelioglu G, Hosal B. The result of late probing in congenital nasolacrimal duct obstruction. Orbit. 2007;26:1–3.PubMedCrossRefGoogle Scholar
  23. 23.
    Sener EC, Onerci M. Reappraisal of probing of the congenital obstruction of the nasolacrimal system: is nasal endoscopy essential? Int J Pediatr Otolaryngol. 2001;6:65–8.CrossRefGoogle Scholar
  24. 24.
    Stevens JL. Success rates of nasolacrimal duct probing at time intervals after 1 year of age. Ophthalmology. 1998;105:1309–10.CrossRefGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2013

Authors and Affiliations

  1. 1.Department of Ophthalmology, Ministry of HealthAnkara Training and Research HospitalAnkaraTurkey

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